American hospitals improved womens survival rates by 11 percent for cardiac disease and stroke from 2001 through 2003, according to a study released this summer by Health Grades Inc., a Golden, Colo.-based health-care ratings company.


A quality chasm was clearly visible, though, with the best-performing hospitals registering a 39 percent lower risk-adjusted mortality rate than the poorest-performing hospitals in the treatment of cardiovascular disease, the company said.


Health Grades also announced that based on the study, called Womens Health Outcomes in U.S. Hospitals, it had updated the ratings on its consumer Web site of womens health and maternity care at nearly 1,500 hospitals.


For many cardiac procedures, the difference in mortality rates between the nations best-performing hospitalsthose in the top 15 percentand the poorest-performing hospitalsthose in the bottom 15 percentwas dramatic.


For example, the risk of mortality for women undergoing coronary artery bypass graft surgery (CABG) was 46 percent lower, on average, at the nations best-performing hospitals, compared with the poorest-performing hospitals.


Heart disease and stroke are the first and third leading causes of death among womenkilling nearly one out of every two women and amounting to almost one death every minute. And yet, only a small percentage of women believes that cardiovascular disease is their biggest threat, and only one in five doctors know that CVD kills more women than men each year, says Dr. Samantha Collier, an author of the study and Health Grades vice president of medical affairs. We applaud efforts by the American Heart Association and others who have increased womens awareness of risks, and we applaud the hospitals that are improving their quality so quickly.


The study finds that:


Best-performing hospitals overall improvement rate was nearly 13 percent during the years 2001 through 2003, which compared with an overall average improvement rate of less than 6 percent among the poorest-performing hospitals.


The greatest improvement across the board in womens mortality was in CABG surgery, at 16 percent, while the smallest improvement in womens mortality from 2001 to 2003 is in stroke, at 3 percent.


The widest improvement gap between the best-performing and poorest-performing hospitals was in heart failure. The best-performing hospitals showed an average of nearly 24 percent improvement from 2001 to 2003, and the poorest-performing hospitals improved an average of about 4 percent.


The greatest differences in womens cardiac and stroke outcomes between the best-performing and poorest-performing hospitals was in what are called percutaneous coronary interventions (PCI), such as angioplasties, heart failure, and CABG surgery. On average, women treated at the best-performing hospitals had a 43 percent lower risk of mortality for PCI, a 44 percent lower risk of mortality for heart failure, and a 46 percent lower risk of mortality for CABG surgery.


The third annual study analyzed womens outcomes from more than 1,500 hospitals in the 17 statesincluding Washingtonthat publish data, representing about 58 percent of the U.S. population. The study examined womens outcomes from CABG, valve-replacement surgery, PCI, acute myocardial infarction or heart attack (AMI), heart failure, and stroke.


We now know that womens average outcomes for cardiovascular care can vary by as much as 46 percent between the best-performing and poorest-performing hospitals, says Dr. Collier. Women must arm themselves with information to make informed decisions and seek out the high-quality hospitals in their area.


The results of the study are available to consumers free of charge at HealthGrades Web site, www.healthgrades.com, where hospitals receive quality ratings in 28 different procedures and diagnoses. The full methodology also can be found on the Web site.


Spokanes two largest hospitals, Sacred Heart Medical Center and Deaconess Medical Center, were among five Eastern and Central Washington hospitals that were rated by HealthGrades, and all five hospitals received as expected, or average, ratings, according to the Web site.


The ratings were based on outcomes in two areasobstetric services and female cardiac and stroke mortality. Sacred Heart was the only one of the five to be rated poor in obstetric services, but also the only one to be rated better than expected in female cardiac and stroke mortality.


Virginia Mason Medical Center, in Seattle, was the only hospital in Washington to be recognized by Health Gradeslast year as wellfor clinical excellence, meaning it was among the highest scoring of the nations full-service hospitals. However, Sacred Heart is one of only two hospitals in the statethe other is Good Samaritan Hospital and Rehabilitation Centerto be recognized by Health Grades for patient safety both this year and in 2004.


Health Grades provides ratings and profiles of hospitals, nursing homes, and physicians to consumers, corporations, health plans, and hospitals.