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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.

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The Dartmouth Atlas of Health Care is based at The Dartmouth Institute for Health Policy and Clinical Practice and is supported by a coalition of funders led by the Robert Wood Johnson Foundation, including the WellPoint Foundation, the United Health Foundation, the California HealthCare Foundation, and the Charles H. Hood Foundation.