Post-heart attack survival may depend on choice of hospital
Staff Writer |
Older heart attack victims who receive immediate high-quality care from their hospital often wind up with a long-term survival advantage, a new study reports.
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Medicare recipients can gain as much as a year of additional life if they are treated at a hospital that has a better track record of keeping all heart attack patients alive for the first 30 days after their emergency, the researchers found.
"It really does make a difference where you go for care," said study author Dr. Emily Bucholz, a resident physician at Boston Children's Hospital. "It's not just about surviving that acute period. The benefits you accrue by being treated at a hospital that does really well will persist over your entire remaining life span."
In the study, researchers reviewed nearly 120,000 Medicare-covered heart attack patients treated at 1,824 hospitals across the United States between 1994 and 1996. The review included an average 17-year follow-up to track how long the patients lived.
Hospitals were ranked as "high-performing" or "low-performing" based solely on the 30-day survival rates of the heart attack patients, who were an average of 76 years old.
The research team discovered that victims treated at so-called "high-performing" hospitals had an overall increased life expectancy, compared to others treated at hospitals where more patients die during the first month of care. But the study did not prove a cause-and-effect relationship between level of hospital care and longer life.
The average survival advantage amounts to between nine months and a year, the investigators found.
"One year is actually a fairly substantial amount of time for these patients," Bucholz said. "From a policy level, investing in initiatives that improve short-term performance actually have long-term implications for patient outcomes."
The study did not examine what helped some hospitals provide better care for heart attack patients, but Bucholz said the "general consensus is it's a lot of factors." ■