Hospital choice could determine survival after a heart attack

Where you go for heart attack care may matter for both your short- and long-term risk of death, according to a new study by Yale School of Medicine researchers appearing in the New England Journal of Medicine.

"Our findings suggest that investing in initiatives to improve short-term hospital performance might also improve long-term patient life expectancy," said first author and Yale School of Medicine graduate Dr. Emily M. Bucholz, who is now a resident at Boston Children's Hospital.

Risk-standardized mortality rates are widely used to measure quality and gauge hospital performance, but it was not known whether patients treated at hospitals with high performance on these short-term measures live longer than those treated at hospitals with poor performance.

To find out, the Yale team used data from the largest medical record study of patients with myocardial infarction ever conducted. Bucholz and the team looked at life expectancy to measure long-term survival because it is a metric that is easily interpreted and meaningful to patients.

They found that patients treated at high-performing hospitals (i.e. those with better 30-day survival rates) lived an average of 9 to 14 months longer after heart attack than those treated at low-performing hospitals.

The team also found that the higher life expectancies of patients treated at high-performing hospitals arose from differences in survival during the first 30 days. "Our study shows that high-performing hospitals aren't just keeping patients alive in the short term; they're keeping patients who otherwise may have died healthier over the long term," said Bucholz.