Menifee Valley Medical Center Ranked "Worse" For Hip Fracture Conditions

Yesterday, the Office of Statewide Health Planning and Development (OSHPD), a California agency that studies the effectiveness of hospitals, announced the results of a study regarding mortality rates at 335 California hospitals for six specific diagnoses and six specific procedures.

Menifee Valley Medical Center was among those studied.

With regards to patients being treated for hip fractures, MVMC was rated "worse" by the OSHPD, where 7.3% of the 84 cases resulted in deaths.

These cases involved hospitalizations in 2009.

Compared to the other hospitals in the study, the statewide average for hip fracture-related deaths was 2.4%.

In 2008, MVMC's mortality rate for hip fractures was much lower, at 4.0% out of 84 cases.

The rating of "worse" does not mean that MVMC was the worst hospital out the 335 studied. It only means the mortality rate for hip fractures had reached a high enough threshold to be considered unusual.

But MVMC showed lower mortality rates for the five other diagnoses studied, particularly with "Acute Stroke", which was well below the statewide average...

Mortality Rates 2009
Hospital	Acute Myocardial Infarction	Congestive Heart Failure	Acute Stroke	Gastro-Intestinal Hemorrhage	Hip Fracture	Pneumonia
Statewide Average	7.1%	3.3%	10.4%	2.3%	2.4%	4.6%
Menifee Valley Medical Center	6.3% (12; 76)	2.3% (5; 197)	5.5% (3; 75)	3.9% (4; 119)	7.3% (6; 84)	4.9% (8; 148)
Hemet Valley Medical Center	7.7% (32; 196)	3.5% (19; 415)	10.1% (18; 221)	1.5% (4; 264)	1.5% (3; 186)	5.4% (25; 340)
Rancho Springs Medical Center	7.4% (18; 128)	2.3% (11; 498)	10.1% (29; 295)	0.9% (2; 250)	1.6% (2; 159)	4.0% (18; 481)

Mortality Rates 2008
Hospital	Acute Myocardial Infarction	Congestive Heart Failure	Acute Stroke	Gastro-Intestinal Hemorrhage	Hip Fracture	Pneumonia
Statewide Average	7.5%	3.4%	10.6%	2.4%	2.7%	4.8%
Menifee Valley Medical Center	11.8% (28; 125)	3.4% (6; 175)	4.9% (3; 78)	4.4% (3; 93)	4.0% (2; 84)	5.4% (9; 188)
Hemet Valley Medical Center	9.0% (32; 202)	5.7% (23; 431)	12.2% (26; 227)	3.6% (10; 251)	2.8% (6; 188)	5.9% (23; 340)
Rancho Springs Medical Center	6.8% (12; 111)	1.9% (9; 460)	8.0% (22; 290)	2.0% (4; 262)	1.3% (2; 156)	5.1% (16; 416)

nn% = mortality rate
(nn;nnn) = number of deaths; number of cases
* Inland Valley Medical Center was not included in the study.

The OSHPD describes these mortality rates as "indicators of healthcare provider quality, but are not definitive determinations of quality". They're meant to serve as a point for further investigation and in-depth analysis.

Rick Dicapo, administrator for MVMC, takes issue of the numbers with regards to the six hip fracture deaths, pointing out that the study didn't take into count additional factors. In a letter to the OSHPD dated Dec 17, 2010, Dicapo states...

"All of the measures for MVMC fell within the expected outcome category except for one. Following a review of the 6 cases cited for MVMC, we found that all of the patients had multiple co-morbidities and all were greater than 85 years old. It should also be noted that each patient had DNR (do not resuscitate) orders. If these factors were taken into account we believe our results would demonstrate lower mortality rates."

To MVMC's defense, they had far fewer cases than compared to Hemet Valley Medical Center and Rancho Springs Medical Center, hence considering the law of averages, the mortality rates are not a good indication of the service provided at MVMC. But then again, that doesn't explain why their mortality rates are considerably lower for "Acute Stroke".

You can review the data yourself here:
http://www.oshpd.ca.gov/hid/products/PatDischargeData/AHRQ/iqi-imi_0809.html