FRHG grades mixed

Fremont-Rideout Health Group was rated in the top 10 percent for maternity care last week by a healthcare ratings company, but Consumer Reports said the hospital is more "aggressive" when treating the elderly.

A study by HealthGrades, an independent healthcare ratings company, researched medical records of maternity patients on Medicare between 2004 and 2006.

It found that best-performing hospitals had almost 51 percent fewer maternal complications among women who had vaginal births compared to poor-performing hospitals. Top hospitals also had 76 percent fewer women undergoing cesarean section births.

This five-star rating, which indicates the hospital has below-average mortality or complication rates for that particular procedure, was well received among hospital administration.

"Women don't need to leave town to have a baby," Fremont-Rideout Health Group CEO Theresa Hamilton said.

Records for more than 12.5 million hospital deliveries were analyzed by HealthGrades from 1,440 hospitals from 2004 through 2006.

About 2,400 babies are delivered at Fremont Medical Center each year, Hamilton said.

Fremont hospital, in Yuba City, is the location of the health group's maternity ward.

Hamilton said the five-star ratings puts Fremont-Rideout among the top 10 percent of the nation's hospitals or maternity care.

FRHG also received a five-star rating for valve replacement surgery, treatment of pulmonary embolisms and appendectomies.

The elderly, though, may want to shop around for care, according to Consumer Reports' Health Rating Center.

That report, compiled by Dartmouth Atlas Project, listed Rideout Memorial Hospital in Marysville among the most aggressive when patients 65 years or older are treated for the top nine leading causes of death. Those causes range from congestive heart failure to diabetes with organ damage.

A hospital ranked with aggressive care means a patient goes through frequent diagnostic tests and doctor visits, are more reliant on specialists and have prolonged hospital stays, spend more time in intensive care units and have a higher out-of-pocket expense.

Quality of care, however, is not analyzed.

The report compared experiences of more than 4 million Medicare patients at 2,800 hospitals throughout the country over a two-year period.

On average a patient stayed 21 days at Rideout Memorial and had an average of 59 hospital visits, according to Consumer Reports. Woodland Healthcare, in Woodland, was the most conservative in the Sacramento region with 13.7 days in the hospital and 43.2 doctor visits.

Rideout Memorial ranks in the 35th percentile nationally for the intensity of care, according to Consumer Reports.

Dr. Robert Plass, chief medical officer for Fremont-Rideout, said it is challenging to know what to make of the study because a number of factors could affect the statistics including how sick a patient is when they go to the hospital to the fact that Rideout is the only hospital in the Yuba-Sutter area.

"Someone living in the Sacramento area could potentially go to a number of different hospital," Plass said. "So the number of days spent in a hospital those last years of life could be skewed."

Plass said Rideout Memorial is not keeping patients longer than necessary.

"We are not, in affect, holding on to patients," he said.

Plass said it is true that the longer a patient stays in a hospital the greater the risk of infection, but the same risk occurs if a patient ignores doctor's orders.

"Yes, if you're in a hospital more often you are more likely to get a hospital-based infection or a hospital-based error," Plass said. "But not taking medicines as prescribed could affect the amount of time you spend in a hospital as well."

Statewide, Sacramento, which includes Rideout Memorial, was among the conservative counties analyzed. Los Angeles County had the most aggressive care in the state.

Nationally, California ranked in the 90th percentile for aggressive care. New Jersey was listed as the most aggressive.

"Our average length of stay is well within national standards," Plass said of Rideout. "Like many other statistics Rideout is potentially higher than others in the region, but Southern California hospitals are ranked much higher."

Contact Appeal repor-ter Andrea Koskey at 749-4709 or akoskey@appealdemocrat.com