Death Rates in Puerto Rican Hospitals Higher Than in States

Jack Gillum, USA Today, July 14, 2009

Patients in Puerto Rico die at statistically higher rates from heart attack, heart failure and pneumonia than those admitted to mainland hospitals, a USA TODAY analysis of new government data shows.

While 11.6% of patients in the states admitted for pneumonia die within 30 days, that number rises to almost 15% in Puerto Rico. Death rates for heart attack also crest above average (18.6% vs. 16.5%) and are slightly higher for heart failure (12.1% vs. 11.2%).

And the rate at which patients were readmitted to Puerto Rican hospitals within a month of discharge also edged up, according to the data. In particular, pneumonia patients landed back in a hospital bed 19.4% of the time, vs. 18.2% in the states.

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Yet the problem in Puerto Rico may run deeper: The island’s several dozen hospitals may lack money for infrastructure, new equipment and more doctors, according to a report last month by the Puerto Rico Health Care Parity Coalition.

The report said Puerto Rico receives about $20 per Medicaid participant vs. $330 in the states, meaning that, all things considered, hospitals may have fewer dollars to spend on facilities and patient care. Since 1997, the report found, Medicaid reimbursement costs in Puerto Rico have increased by more than 300% to roughly $1.7 billion in 2008; federal contributions, meanwhile, have increased by about 96% during that time.

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Peter Ashkenaz, a spokesman for the U.S. Centers for Medicare & Medicaid services, says Puerto Rico received about $180 million more this fiscal year in payments for federal health care programs, which includes $100 million in federal stimulus money.

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