醫院安全指數最高的十大州

生老病死，是人之常情，每個人都迴避不了的經歷和生命過程。所以，對於醫院的質量，每個人都會很在乎。那麼，什麼樣的醫院就是比較安全的醫院呢？大致估計一下也不難猜到：比較低的醫療事故，比較低的誤診和治療耽誤。

別以為，只有在中國才有因為誤診和延遲治理而喪失生命的情況出現，在美國，每年也有多達五萬到十萬的病人，就是因為這樣、那樣的醫療事故和質量問題，而失去生命的。

醫療事故之中，很常見的一種是，手術之後，過於忙碌的醫生們，時不時的會將手術用的器材和物件，遺忘在病者的身體內。誤診也時不時的會因為耽誤，而造成不必要的傷亡。更有甚者，很多人由於沒有得到及時的正確診斷，因為延遲而失去了生命。

以這些指標為核心，人們打造了一套量化的衡量指標，然後就用這些指標來衡量美國五十大州，來尋找最安全的十大州。結果，以平均壽命比較長而聞名的東北部三個州，因為擁有最高比例的優秀醫院，而獲得最佳的名號。

同時，感覺上不應該好的州，像伊利諾伊州和加州也同樣榜上有名。所以，很多時候你還不能自以為是，否則，就會犯錯誤。

還有，我們過去一直以為，只有生活在比較寒冷地區的人，才會有比較高的平均壽命，但是，加州的平均壽命在這裡看來也不低，由此可見，氣候和溫度的高低，還不是一個絕對的決定平均壽命的要素。加州人的平均壽命，在這十大州裡面，僅次於明尼蘇達州，而被排在第二位。看來，地震和常年易見的山火，也還是無法撼動加州人開開心心過日子的心境的。

在有些州，基於類似的指標衡量，居然沒有一家醫院的分數超過B的水準——只是還行，沒有一家算得上是優秀。而在這裡標出的十家“模範”州，則是那些獲得A比例比較高的十大州。做得最好的是馬薩諸塞州和緬因州，它們都有大約三分之二的醫院被視為優秀；第三名的只有一半醫院有這樣的業績，其它的則在三分之一到二分之一之間徘徊。

即使是在那些優秀比例比較高的州，也有很不怎麼地的醫院存在。

所以，你還是得注意你所選擇的醫院的不同，而不僅僅只是所居住州的差異。

連接：

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美國犯罪率最高的十大都市

The States with the Safest Hospitals

June 18, 2012 by 247wallst

According to the National Institutes of Health, nearly 50,000 to 100,000 patients die in U.S. hospitals each year as the result of lapses in safety. Recently, the Leapfrog Group, a nonprofit promoting transparency and safety in hospitals, released its first-ever Hospital Safety Score. The study analyzed data from 2,652 hospitals from across the country based on 26 different safety-related measures. Each hospital received a score of A, B or C. Grades for hospitals receiving D and F have not yet been finalized.

Some states have much safer hospital systems than others. In several states, 40% or more of reporting hospitals received the best possible score. In others, not one hospital scored better than a B. Based on Leapfrog’s report, 24/7 Wall St. identified the states with the largest percentage of hospitals receiving an A.

In an interview with 24/7 Wall St., Melissa Danforth, Interim Senior Director of Leapfrog’s Hospital Ratings, explained the importance of the report compared to other national hospital rankings. “The Hospital Safety Score is unique,” according to Danforth, because Leapfrog only considers what puts a patient’s safety at risk, instead of “looking at the reputation of the hospital.” Danforth said, “We’re really looking to, and wanting to draw attention to, things that could happen to you in a hospital that could kill you.”

Danforth explained that hospitals that received an A grade tended to have close to perfect scores for particular safety measures. Incidence of patient falls, trauma, including broken bones or injuries that occur during a patient’s stay, and the likelihood of receiving a central-line associated bloodstream infection (CABSI) — a dangerous infection that can occur during certain procedures — are particularly low among the safest hospitals.

Similarly, the states with the highest percentage of hospitals receiving an A performed better on these important measures compared to the national average. For most of the states on this list, incidents of falls, trauma and CABSIs are below the national average. In Massachusetts, one of the states with the safest hospitals, incidence of particularly bad bedsores — another critical safety measure — is one-third the national rate.

States with the healthiest hospitals do not necessarily have healthy populations. In addition to the safety scores provided by Leapfrog, 24/7 Wall St. also considered a variety of health-related metrics from statehealthfacts.org, part of The Henry J. Kaiser Family Foundation. Life expectancy, incidence of cancer and diabetes, and heart disease mortality rates were no better in the states with the safest hospitals than the national average.

These are the states with the safest hospitals.

10. Minnesota
> Hospitals with A grade: 37%
> Number of hospitals with A grade: 17
> Life expectancy at birth: 80.85 years
> Cancer death rate per 100,000: 173.7

More than one-third of Minnesota hospitals received an A grade by Leapfrog’s Hospital Safety Score. The state’s hospitals were especially successful at minimizing errors that could potentially occur during inpatient care. For all four criteria used by Leapfrog in assessing life-threatening hospital errors, Minnesota hospitals averaged fewer errors per 1,000 people than the nation’s average. The Mayo Clinic in Rochester, one of the facilities receiving an A, outperformed national averages in all patient safety indicators (PSIs) dealing with surgery, procedures and childbirth.

9. Delaware
> Hospitals with A grade: 40%
> Number of hospitals with A grade: 2
> Life expectancy at birth: 78.32 years
> Cancer death rate per 100,000: 198.4

Out of the five Delaware hospitals reviewed by Leapfrog, two received an A. The Beebe Medical Center in Lewes and Christiana Hospital in Newark have low levels of falls and traumas. This is in contrast to other hospitals in the state where rates of patients falling are more than double the national average. All five reporting Delaware hospitals have fewer patients who suffer postsurgical wound splits than the national average.

8. California
> Hospitals with A grade: 41%
> Number of hospitals with A grade: 97
> Life expectancy at birth: 80.37 years
> Cancer death rate per 100,000: 166.9

Leapfrog reviewed 238 California hospitals — more than any other state in the country. The hospitals measured averaged 0.44 trauma and falls per 1,000 patients, which is lower than the national average of 0.57. One of the state’s Orange County hospitals, St. Joseph, has a rate of death of just  67.5 for every 1,000 serious treatable complications stemming from surgery. This makes St. Joseph one of the best in the country in this measure. Also, the state has 66 separate hospitals that recorded no serious falls or trauma during hospital stays.

7. Michigan
> Hospitals with A grade: 44%
> Number of hospitals with A grade: 34
> Life expectancy at birth: 77.89 years
> Cancer death rate per 100,000: 191

Hospitals in the state of Michigan generally do a good job keeping patients safe. Cumulatively, these hospitals limited serious incidents of foreign objects left inside patients after surgery, air embolisms, pressure related ulcers, as well as falls and other traumatic injuries. Of the hospitals in the state that scored an A, 15 fully met Leapfrog’s standards for effective ICU staffing and received perfect scores in the survey for hospital leadership, mitigation of risk, quality of the nursing workforce and hand hygiene.

6. Virginia
> Hospitals with A grade: 44%
> Number of hospitals with A grade: 24
> Life expectancy at birth: 78.53 years
> Cancer death rate per 100,000: 188.6

Virginia hospitals have lower rates of accidental cuts or tears from medical treatment than the U.S. average. Virginia hospitals are also better at preventing death from serious treatable complications after surgery, with a rate that is substantially lower than the national average. Hospitals in Virginia have low averages of foreign object retention after surgery and pressure ulcers, also known as bedsores.

5. Tennessee
> Hospitals with A grade: 48%
> Number of hospitals with A grade: 31
> Life expectancy at birth: 76.2 years
> Cancer death rate per 100,000: 206

With higher rates of cancer death and infant mortality than any other state on this list, as well a lower life expectancy, Tennessee needs hospitals that are both good and safe. Fortunately, 48% of the state’s hospitals receive A grades from Leapfrog, while only about 33% of hospitals receive C grades. For all of Leapfrog’s safe practice measures, Tennessee’s hospitals receive above-average score. One hospital performing especially well is Vanderbilt University Hospital, which received high scores for its surgery-related antibiotic regimens, as well as for its handling of urinary catheters and prevention of blood clots following surgery.

4. Illinois
> Hospitals with A grade: 48%
> Number of hospitals with A grade: 51
> Life expectancy at birth: 78.76 years
> Cancer death rate per 100,000: 191.3

Leapfrog surveyed 106 Illinois hospitals. While nearly half received an A grade, the reviewed state hospitals actually performed worse than the national average on many of the key safety metrics, including the frequency of central-line associated bloodstream infections. However, in many other measures Illinois hospitals performed well, including having a low average of the number of deaths from treatable medical complications after surgery. However, many of the state’s 51 hospitals that received an A scored much better than the national average in preventable deaths and ulcers.

3. Vermont
> Hospitals with A grade: 50%
> Number of hospitals with A grade: 3
> Life expectancy at birth: 79.7 years
> Cancer death rate per 100,000: 179.7

Though only six Vermont hospitals reported information to Leapfrog, three of these earned A grades. Brattleboro Memorial Hospital received above-average ratings for all Surgical Care Improvement Project (SCIP) measures. The hospital also recorded perfect scores in preventing complications related to air embolisms and pressure ulcers. Southwestern Vermont Medical Center and Central Vermont Medical Center similarly recorded a strong performance, with each receiving above-average SCIP ratings. The quality of medical care in the state may well have major benefits for its residents as heart diseases resulted in just 138 deaths per 100,000 people, far less than the nationwide average of 186.5 deaths.

2. Maine
> Hospitals with A grade: 74%
> Number of hospitals with A grade: 14
> Life expectancy at birth: 78.68 years
> Cancer death rate per 100,000: 199.7

Citizens of Maine have lower levels of death as a result of heart disease — 12 percentage points lower than the national average — but a higher rate of deaths from cancer than the U.S. average. After surgery, patients in Maine hospitals are less likely to experience breathing difficulties or respiratory failure than they would in the average hospital in the United States. All of the 19 Maine hospitals reporting averaged exceptional scores in hand hygiene and care for patients on ventilators. Only three of the state’s 19 graded hospitals received a C.

1. Massachusetts 
> Hospitals with A grade: 76%
> Number of hospitals with A grade: 47
> Life expectancy at birth: 80.1 years
> Cancer death rate per 100,000: 186.6

Massachusetts has one of the healthiest populations in the country. Average life expectancy from birth in the state is 80.1 years, the sixth-highest in the country. The state also has one of the best — and most expensive — medical systems in the country. The state’s university system produces some of the most prestigious hospitals in the country. More than three-quarters of the state’s hospitals in Leapfrog’s survey received A grades. Just 20 of the of the state’s 62 reporting hospitals failed to record spotless records for pressure ulcers, and two-thirds had a better-than-average percentage of patients receiving the correct type of antibiotics.

-Michael B. Sauter, Alexander E. M. Hess and Lisa A. Nelson