Inpatient Mortality for High-Volume Conditions
Monitoring and improving health care quality in the United States is a key priority for health policymakers, payers, providers, and patient advocates. Hospital inpatient mortality is one quality measure that can reflect both improvements in health care and shifts in where end-of-life care takes place over time.
Previous trends in inpatient mortality suggest that rates have been decreasing for high-volume conditions, such as acute myocardial infarction (AMI), congestive heart failure (CHF), stroke, and pneumonia. Continued study of these trends can help researchers and policymakers assess the impact of health care quality efforts.
Trends in Observed Adult Inpatient Mortality for High-Volume Conditions, a statistical brief from the Healthcare Cost and Utilization Project (HCUP), examines trends in observed inpatient mortality rates for AMI, CHF, stroke, and pneumonia for adults aged 18 years and older, as well as changes in these rates for select patient subgroups.
- Observed inpatient mortality rates among adults declined between 2002 and 2012 for four high-volume conditions: 45 percent decrease for pneumonia, 41 percent decrease for AMI, 29 percent decrease for CHF, and 27 percent decrease for stroke.
- Inpatient mortality for pneumonia demonstrated the largest decrease of the four conditions across subgroups:
- Decreases in the inpatient mortality rate for pneumonia were largest for Medicaid and uninsured patients (56 and 55 percent, respectively).
- Pneumonia mortality decreased by nearly half for patients in all community income groups.
- Decreases in mortality for CHF and stroke were largest among patients from the poorest communities (34 percent decrease for CHF and 30 percent decrease for stroke).
- Uninsured patients had the largest decrease in inpatient mortality for stroke (42 percent) compared with Medicare, Medicaid, and privately insured patients.
- Inpatient mortality for AMI decreased by approximately 40 percent in rural (42 percent), metropolitan (41 percent), and micropolitan (40 percent) areas.