The best and worst US states in heart attack care

Somebody told me once that it all boils down to the right location, whether it’s real estate, business venture, or vacation. It seems it is the same when it comes to health care. In previous posts for example, I have tackled how geography can influence health, from based on the levels of air and noise pollution as well as UV radiation

A study published in the July issue the journal Circulation lists the best and worst states to be in, in order to survive a heart attack. This is based on the quality of care that hospitals in the states can deliver in terms of the treatment and management of heart attack and heart failure.

Of the best states, New Jersey tops the list, with “the least deaths and fewest hospital readmissions following a heart attack or heart failure.” The top 5 states are listed below:

• New Jersey
• Vermont
• New Hampshire
• Washington
• Oregon

The US national average for heart attack mortality is 16.6% and 11.1% for heart failure. The best performing states have a maximum mortality rate of 10.9 and 6.6% for heart attack and heart failure, respectively.

Most of the states are sort of middle of the road when it comes to heart disease care but some states performed worse than the others. The 5 worst states to be in for patients of heart attack or heart failure are:

• Oklahoma
• Arkansas
• Tennessee
• Missouri
• Louisiana

In these states, mortality rates from heart attack were about 24.9% and rates from heart failure were about 19.8%.

Aside from mortality rates, the rankings also took readmission rates into account. In the worst performing hospitals, 1 in 4 heart failure patients and 1 in 5 heart attack patients were readmitted within 30 days of their first admission due to many reasons including:

• Medication problems
• Infection
• poor follow up care
• Recurrence of the heart attack or failure.

Readmission and complications are preventable and in preventing these, deaths are also prevented.

According to study author Dr. Gregg Fonarow, professor of cardiovascular medicine at UCLA

“Being able to prevent preventable deaths is very important. Preventing early hospitalization again is also very important. The large difference highlights that more could be done.”

The researchers, however, were quick to emphasize that the ratings were general averages and do not necessarily reflect the performance of all hospitals in the said state. The state of Florida, for examples, has hospitals which were ranked among the bets but also has others which were ranked among the worst. A more detailed ranking of individual hospitals clinics according to different therapeutic areas is given by the US News and World Report. The top 4 hospitals are

• Johns Hopkins Hospital
  Baltimore, MD
• Mayo Clinic
  Rochester, MN
• Ronald Reagan UCLA Medical Center
  Los Angeles, CA
• Cleveland Clinic
  Cleveland, OH

None of these hospitals are located in the top ranking states.