In five of 22 medical-care categories, the Hospital of the University of Pennsylvania (HUP) had death rates that were significantly higher than expected in 2000, according to a report compiled by the Pennsylvania Health Care Cost Containment Council. The independent state agency’s Hospital Performance Report for Southeastern Pennsylvania found that HUP had unexpectedly high mortality rates in vascular operations, kidney and urinary-tract infections, kidney failure, hip operations (other than hip replacements), and septicemia (blood infections).
According to Dr. P. J. Brennan, chief of health-care quality and patient safety for the University of Pennsylvania Health System (which includes HUP), the report fails to take into account a number of important factors, and thus “paints with a broad brush.” One factor, he says, is that HUP is the “most complex hospital in the region,” and thus accepts patients with “highly complex” problems and more severe underlying conditions than other hospitals.
“We are the hospital that physicians and patients rely on when no one else is able or willing to handle the problem,” he said. “We take patients in transfer from hospitals that have open-heart programs that are rated very favorably, yet they will send their most complicated patients to us. And we’re very proud of that. But it can affect our mortality rate and benefit theirs. We’re not going to change that, but we need to be clear about why that’s happening.
“We have had expert clinicians do a review of every one of the death charts, and we have not found quality problems in any one of them,” he added. “We believe that every one of the deaths was expected.”
U.S. News & World Report named HUP one of the nation’s top hospitals in its recent “Best Hospitals” issue, ranking it 14th in the nation and highest in the Delaware Valley in 13 specialties.