Hospitals rated in the top 5 percent in the U.S. have a 29 percent lower risk-adjusted mortality rate and are improving their clinical quality at a faster pace than other hospitals, according to a study issued Jan. 26 by HealthGrades, a healthcare ratings organization.

Hospitals rated in the top 5 percent can be found at the HealthGrades’ Web site. In addition to having lower risk-adjusted mortality rates, hospitals in the top 5 percent also had risk-adjusted complication rates that were 9 percent lower than all other hospitals.

Crossing the regional healthcare divide, the following states had no hospitals in the top 5 percent: Alaska, Arkansas, Hawaii, Idaho, Maine, Massachusetts, Mississippi, Nevada, New Hampshire, New Mexico, Oklahoma, Rhode Island, Vermont, Washington, D.C., and Wyoming.

In its eighth year, the HealthGrades Annual Hospital Quality and Clinical Excellence report examines patient outcomes for 26 medical procedures and diagnoses at all 5,000 nonfederal hospitals in the U.S., based on 40 million hospitalization records from 2006, 2007 and 2008 obtained from the Centers for Medicare & Medicaid Services. Participation is not voluntary, and hospitals cannot opt out of being rated.

For each hospital, risk-adjusted mortality and complication rates are evaluated across 26 procedures and diagnoses, from heart attack treatment to valve-replacement surgery to total knee replacement.

The study of mortality and complication rates identifies an “elite group of hospitals that are setting the benchmark for outstanding patient outcomes," said author Rick May, MD, vice president of research and consulting at HealthGrades. "And…these hospitals are not standing still. In fact, the data show that they are continuing to improve their patient outcomes at a faster rate, reflecting a commitment to quality that stands as a model."

The 2010 study of Medicare patients also found:

• Thirty-six states have one or more hospitals in the top 5 percent. Delaware has the highest percentage of Distinguished Hospitals for Clinical Excellence at 50 percent of eligible hospitals, followed by Maryland, Minnesota, Florida and Connecticut.
• 150,132 patient deaths among Medicare patients may have been prevented and 13,104 in-hospital complications among Medicare patients may have been avoided if all hospitals performed at the level of the top 5 percent of hospitals
• The top 5 percent of hospitals showed greater overall improvement in risk-adjusted mortality from 2006 through 2008, with an average of 13.9 percent improvement versus 10.4 percent improvement for all other hospitals.