About Our Hospital Data
Hospital-specific data from the Dartmouth Atlas project reflect the
treatment of Medicare patients with serious chronic illnesses who
were in their last two years of life. The data are not restricted to
services delivered in acute care hospitals; they include care delivered
in outpatient facilities, skilled nursing and long-term care hospitals,
and services delivered by home health agencies and hospice. Once a
patient is assigned to a hospital -- based on the plurality of his or
her medical admissions during the last two years of life -- all
treatment received by that patient is attributed to that hospital,
regardless of where it was actually delivered. Because seriously ill
patients are highly loyal to the hospital where they receive their
care, hospital-specific utilization rates reflect the approach to
chronic disease management of both the hospital and the physicians who
practice in association with that hospital.
Patients with surgical admissions only, as well as patients who were
never hospitalized during the last two years of life, were excluded
from these hospital-specific analyses. The surgery may not have been
offered by the hospital and medical staff that usually provided their
care; in other words, a patient whose only hospital admission was for
bypass surgery could only be assigned to the hospital where the surgery
was performed, even if most of his or her care was provided by
physicians associated with another hospital. Excluding these patients
also reduces the likelihood that a surgical complication was the cause
of death.
We report data for acute care general hospitals; those that provide a
range of acute care services to Medicare fee-for-service patients. The
study was limited to hospitals with large enough populations to result
in statistical stability and retain the confidentiality of patient
information. Inpatient data for hospitals with at least 80 deaths
during the study period are provided on the web site; for Part B data,
which is based on a 20% sample of deaths, a hospital had to have at
least 400 total deaths (80 deaths in a 20% sample) during the study
period to be included.