About 65 percent of Utah hospitals have higher-than-expected death rates for Medicare patients, according to an annual, controversial government report released Wednesday.

Included are many of the state's largest hospitals, such as LDS, University of Utah, Utah Valley Regional Medical Center, Holy Cross, Cottonwood and HCA St. Mark's.And some Utah hospitals greatly exceed expected death rates for the types of patients and illnesses they treat. For example, Fillmore Community Medical Center was 94 percent higher than expected, San Juan Hospital in Monticello was 83 percent higher and Holy Cross in Salt Lake City was 58 percent higher.

The U.S. Health Care Financing Administration - which oversees Medicare - annually releases national death rates for each hospital that treats Medicare patients. It also figures what their death rates should be, based on national averages for the types of patients and illnesses each facility treats.

HCFA Administrator Gail R. Wilensky cautioned that such death See complete list on B3rates "are not a direct measure of the quality of care." But she said large differences between actual and expected death rates are signs that problems may exist.

She said consumers should talk to hospitals and doctors about reasons behind the numbers and what steps may have been taken to correct any problems they disclose.

Hospitals have blasted the report as misleading in each of the four years that it has been issued.

Holy Cross in Salt Lake City, for example, submitted comments printed with the report saying that while such data is useful to hospital administrators seeking signs of problems, "it is not helpful to the general public as a guide to hospital performance and is not a good measure of hospital quality."

It adds, "This data is useful in raising questions related to quality but does not in itself answer them." The government agrees - and stresses that consumers should talk to hospitals about what may be reasonable factors behind apparently high death rates.

An example is comments in the study provided by Bear River Valley Hospital in Tremonton about why it had a 1989 death rate of 50 percent (21/2 times what is expected) for Medicare patients suffering congestive heart failure or heart attacks within 30 days of admittance.

"We transfer the majority of our myocardial infarctions and congestive heart-failure patients to other facilities. Those that we keep are so unstable that they are not good risks for transfer - hence the higher mortality rate," wrote Bear River Administrator Robert F. Jex.

The study provided 1989 death rates for Medicare patients within 30, 90 and 180 days from when they entered a hospital.

It showed that in Utah, 26 of 40 hospitals that treated Medicare patients had higher-than-expected 30-day death rates. Twenty of the 40 had higher-than-expected 180-day death rates.

It also provided the death rates at each hospital for 17 separate conditions or medical procedures, including heart attack, pneumonia, stroke, hip fracture, coronary bypass surgery and hysterectomy. Copies of the study with such detailed information are available from the HCFA. Its Washington phone number is 202-727-0735.

Among some of the Utah hospitals that had overall death rates much higher than expected, Fillmore's 30-day death rate was 15.1 percent, compared with the predicted rate of 7.8 percent.

San Juan's was 18.8 percent, compared with the expected 10.3 percent. Its 180-day death rate was a high 31.8 percent, compared with an expected 20.5 percent.

Holy Cross's 30-day death rate was 8.7 percent, compared with the expected 5.5 percent.

Utah hospitals that had death rates much lower than expected included Orem Community Hospital. It's 30-day death rate was 1.9 percent - 72 percent lower than the expected rate of 6.9 percent.

Garfield Memorial Hospital in Panguitch was another. Its 30-day death rate was 2 percent - 59 percent lower than the expected rate of 4.9 percent.