Tài liệu Healthgrades 2012 Trends in Women’s Health in American Hospitals pptx


1
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Healthgrades2012
TrendsinWomen’sHealthin
AmericanHospitals
The2012HealthgradesTrendsinWomen’sHealthinAmericanHospitalsreportevaluatesthe
qualityofcareforwomenatU.S.hospitals.Eachyear,Healthgradesevaluatesgender‐specific
outcomesconcerningwomenforcardiovascularcare,boneandjointhealth,maternitycare,and
gynecologicsurgery.Womenpresentauniquetreatmentchallengeforthehealthcaresystemin
allofthesearea
s,whichspanthespectrumofcarethroughoutawomen’slifetime.
Womenoftenpresentwithheartconditionsatanolderagethanmenandmaypresentwithno
historyofthedisease.Inaddition,womenmayhavelessspecificsymptoms thatseemunrelated
tocardiovasculardiseasean
dheartattack.
1
Researchhasconsistentlyshownthatwomenfare
worsethanmeninthetreatmentofcommoncardiovasculardiseases;theyaremorelikelyto
experiencedelaysincare;andtheyarelesslikelytoreceiverecommendedpreventiveandfollow‐
upcarethantheirmalecounterparts.
2,3,4
Inadditiontocardiovascularcareandboneandjointhealth,Healthgradesalsoevaluatespatient
outcomesinmaternitycareandgynecologicproceduresforacompleteviewofwomen’sunique
careneeds.Formanywomen,hospitalizationduetochildbirthistheirfirstexperiencewith
inpatientcare.Toensurethatmothers‐to‐beandtheirfamilie
sareabletomakethebestdecision
regardingtheircare,itisimportanttohavecomparativeinformationaboutthequalitydifferences
thatexistamonghospitalmaternitycareprograms.
Forthefirstpartofthisstudy,Healthgradesanalyzedin‐hospitalcomplicationandmortalityrates

among16ofthemostcommondiagnosesandp
roceduresamongwomen65andolder,and
identified176ofthenation’s4,783hospitalsthatexcelledinthetreatmentofwomen.
Healthgradesdesignatedthese176hospitalsasWomen’sHealthExcellenceAwardhospitals.
From2008to2010,ifallhospitalsperformedatthelevelofWomen’sHealthExcellenceAward
hospitalsacrossthe16proceduresanddiagnos
esstudied,anadditional39,450womencould
havepotentiallysurvivedtheirhospitalization,and19,062womencouldhaveavoidedamajorin‐
hospitalcomplication.
Comparedtopoor‐performinghospitals,Women’sHealthExcellenceAwardhospitalshad:
 42%lowerrisk‐adjustedrateofin‐hospitalmortalityacrossninedia
gnosesandprocedures
 14%lowerrisk‐adjustedrateofin‐hospitalcomplicationsacrosssevenorthopedicand
vascularprocedures
AlistofWomen’sHealthExcellenceAwardrecipienthospitalscanbefoundinTable3.Hospital
profilescanbefoundatwww.Healthgrades.com,whereyoucanalsoreadthefullmethodology.
Thesec
ondpartofthisreportevaluatesoutcomesinmaternitycareandidentifiesotherkey
statisticsaboutsomeofthemostcommonfemalegynecologicsurgeries.Thebest‐performing
hospitalsformaternitycareandgynecologicsurgeryacross19statescanbefoundinTables4and
5,respectively.
CardiovascularCareforWomen
HealthgradesFindings
Beingawomanincreasedthelikelihoodofdeathincardiovascularsurgeryandacuteheartattacks
whencomparedtomen.Specifically,afteradjustingforageandcomorbidities,womenhada
higherriskofmortalityin:resection/replacementofabdominalaorta,valvereplacementsurgery,
coronarybypasssurgery,andcoronaryinterventionalprocedures.

HOSPITALQUALITYGAPSPERSIST
FemalepatientoutcomesinU.S.hospitals

notonlyvariedwhencomparedtomen’s
outcomes,butalsovariedwidelyamong
hospitals.
Healthgradesidentified176ofthenation’s
hospitalsthatexcelledintheircarefor
womeninthefollowing16common
diagnosesandprocedures.
Complication‐BasedCohorts
 BackandNeckSurgery(WithSpinal
Fusion)
 Bac
kandNeckSurgery(WithoutSpinal
Fusion)
 CarotidSurgery
 HipFractureTreatment
 HipReplacement
 PeripheralVascularBypass
 TotalKneeReplacement
Mortality‐BasedCohorts
 ChronicObstructivePulmonaryDisease
 CoronaryBypassSurgery
 CoronaryInterventionalProcedures
(PTCA/Angioplasty,Stent)
 HeartAttack
 HeartFailure
 Pneumonia
 Resection/ReplacementofAbdominal
Aorta
 Stroke
 ValveR

eplacementSurgery
POTENTIALTOSAVELIVES
Comparedtopoor‐performinghospitals,
hospitalsrecognizedwiththeHealthgrades
Women’sHealthExcellenceAwardhad:
42%
lowermortalityrate
acrossninediagnosesandprocedures
17%
lowercomplicationrate
acrossfiveorthopedicprocedures
Ifallhospitalsnationwideperformedatthe
leveloftheHealthgradesWomen’sHealth
ExcellenceAwardhospitals:
39,450
women’slivessaved
(womenwhocouldhavepotentially
survivedtheirhospitalizations)
19,062
women’scomplicationsavoided
(womenwhocouldhavepotentiallyavoided
amajorin‐hospitalcomplication)

2
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Women’sIncreasedMortalityRisk

Forbothmenandwomen,theuseofbypasssurgeryoracoronaryinterventionalprocedure
(angioplastyorstent)totreataheartattackhasincreasedovertheyears.However,

 In2010,only39.5%ofwomenwhosufferedaheartattackreceivedasurgicalintervention
comparedto54.3%ofallmen.
 Amonghe
artattackpatientsreceivinganintervention,themortalityrateforwomenwas
29.1%higherthanformen.
HeartDiseaseIsthe#1KillerofWomen
AccordingtotheAmericanHeartAssociation,nearlytwiceasmanywomenintheUnitedStates
dieofheartdisease,stroke,andothercardiovasculardiseasesasfromallformsofcancer,
includingbreastcancer.
1
However,only54%ofwomenareawarethatcardiovasculardiseaseis
theleadingcauseofdeathamongwomen.
5

Knowingthatheartdiseaseistheleadingcauseofdeathamongwomen,womenneedtobecome
proactiveaboutpreventingheartdiseaseandunderstandingthesymptomsofaheartattack.
Earlyrecognitionofaheartattackenableswomentotakeimmediateaction.Unfortunately,
women’sheartattacksymptomsareeasilyconfusedformanyotherconditions–bothbywomen
whomayig
noresymptomsandbythemedicalteamtreatingthem.
KnowtheSymptoms
Symptomsofheartdiseaseandheartattackinwomenoftendonotpresentintraditionalways,
addingtothedifficultyofearlyrecognition.Womenmaynothavetheclassic“crushingchest
pain”orpainradiatingtothearm.Infact,mostwomensufferingfromaheartattackhaveno
chestpain.Theirsymptomsaremoresubtle,suchasshortnessofbreathorpalpitations.
Awomansufferingfromaheartattackmaycomplainofnotfeelingwellbutmaydisregardthe
sensationasfatigueorstress.Manywomenexperienceatypicalsymptomspriortoaheartattack,
soitisimportanttoknowthatthesymptom
sofaheartattackmaynotbeasobviousinwomen
comparedtomen.Womenshouldseekpromptmedicalcareiftheyhaveunusualorunexplained

symptoms.
6
Thesymptomsofaheartattackarelistedtotheright.
Despitethefactthat57.9%ofwomenwhohadaheartattackexperiencedshortnessofbreath,
6
a
2010AmericanHeartAssociationstudyfoundthatonly29%ofwomensurveyedidentified
shortnessofbreathasaheartattackwarningsign.
5
Similarly,while39.4%ofwomenexperienced
indigestionpriortotheirheartattack,
6
only15%ofwomensurveyedsitednauseaasawarning
sign.
5

KnowYourRiskofCardiovascularDisease
Majorriskfactorsforcardiovasculardiseasethatcanbeinfluencedbylifestylechoicesinclude:
 Diabetes
 Highbloodpressure
 Highcholesterol
 Obesity
 Tobaccoandalcoholuse
18%
36%
39%
42%
0% 10% 20% 30% 40% 50%
CoronaryInterventional
Procedures(Angioplasty)

CoronaryBypassSurgery
ValveReplacementSurgery
Resection/Replacement
ofAbdominalAorta
KNOWINGTHESYMPTOMSOFA
HEARTATTACKCOULDSAVE
YOURLIFE
Bothmenandwomencanexhibitthe
followingsymptoms:
 Anxietyandrestlessness
 Chestpain,tightnessorpressure,which
canradiatetotheshoulders,back,neck,
jaworarms
 Dizzinessorafeelingofpassingout
(fainting)
 Fatigue
 Indigestion
 Nauseaandvomiting
 Shortnessofbreathorlabored
breathing
 Suddensweating

Heartattacksymptomscommontowomen:
 Abdominalpain
 Achiness
 Anxiety
 Lightheadedness
 Milddiscomfortinthejaw,back,armor
neck(withoutchestpain)
 Overallfeelingofillness

 Sleepdisturbance
WOMEN’SAWARENESS
54%
ofwomensurveyed
areawarethatheartdisease/heartattackis
theleadingcauseofdeathamongwomen.
5

51%
ofwomensurveyed
identifiedfamily/caregivingresponsibilities
astheirprimaryobstacletolivinga
heart‐healthylifestyle.
5
HEARTQUIZFORWOMENONLY
Takethisquiz,basedoninformationfrom
theAmericanHeartAssociation,andsee
howmuchyouknowaboutheartdiseasein
women.
www.bettermedicine.com/category/heart‐
blood‐and‐circulation/heart‐quiz‐for‐
women‐only
RISKASSESSMENT
Takethisassessmenttoestimateyour
10‐yearriskofhavingaheartattack.
hp2010.nhlbihin.net/atpiii/calculator.asp

3
©Copyright2012HealthGrades,Inc.Allrightsreserved.


TheAmericanHeartAssociationrecommendsregularscreeningforriskfactorsbeginningatage
20.Screeningincludesmeasuringbloodpressure,bodymassindex,waistcircumference,and
pulseeverytwoyears,andgettingacholesterolprofileandglucosetest(asimplebloodsugar
test)everyfiveyears.
Yourdoctormaywantyoutohav
emorefrequentscreeningsorvisitsifyouhaveafamilyhistory
ofheartdisease,diabetes,highbloodpressure,highcholesterol,orotherhealthproblems.
ReduceYourRiskofCardiovascularDisease
Manypeoplecantakestepstosignificantlyreducetheirchancesofdevelopingheartdisease:
 Stopsmoking
 Controldiabetes
 Controlhighbloodpressure
 Eataheart‐healthydiettocontrolcholesterollevels
 Getphysicallyactive,withyourdoctor’sapproval
 Loseextraweight
Formoreinformationonstepstomodifycontrol
lableriskfactorsforheartdisease,visit
TakeActiontoBeatHeartDisease(www.bettermedicine.com/topic/heart‐disease/take‐action‐
to‐beat‐heart‐disease)
Bone&JointHealth:HipFractureTreatmentforWomen
HealthgradesFindings
 Womencontinuetomakeupahigherpercentageofadmissionsforhipfracturetreatment
thanmen(73%forwomen,27%formen).
 Adjustingforthefactthatwomencompriseabout57%oftheU.S.populationage65and
older,womenwereadmittedforhipfracturetreatmentatapproximatelytwicetherateof
men.
WomenAreMoreLikelyThanMentoExperienceaHipFracture
Womenaremorelikelythanmentoexperienceahipfracture.Accordingtothe National
OsteoporosisFoundation:
 Awoman’sriskofbreakingahipisequaltohercombinedriskofbreast,uterineand

ovariancancer.
8

 Oneintwowomenolderthan50willhaveanosteoporosis‐relatedfracture.
9

KnowYourRiskofHipFracture
Inadditiontobeingawoman,thereareseveralotherfactorsthatincreasethelikelihoodof
experiencingahipfracture:
 Chronicmedicalconditions,suchasosteoporosisandendocrinedisordersthataffectthe
absorptionofvitaminDandcalcium
 Increasedage
 Nutritionalinsufficiency
 Physicalinactivity
 Tobaccoandalcoholuse
ReduceYourRiskofHipFracture
Manywomendonotrealizehowpotentiallyfatalahipfracturecanbe.Accordingtothe
InternationalOsteoporosisFoundation,themortalityrateofwomenover50whosufferahip
fractureisthesameaswomenover50diagnosedwithbreastcancer.
10
Hereishowyoucan
reduceyourriskofthislife‐threateningcondition:
 Stopsmoking
 Checkyourbonedensity
 Eatahealthydiet,whichincludessufficientlevelsofcalciumandkeyvitamins
 Exerciseregularlytoincreasebonedensity
HEARTFORWOMENACT
TheU.S.legislaturerecentlyreintroduced
theHeartDiseaseEducation,Researchand
Analysis,andTreatmentforWomenAct

(HEART).
TheHEARTforWomenActisdesignedto
educatethepublicandphysicians to
recognizeandeffectivelytreat
cardiovasculardiseaseinwomen.
Moreimportantly,thelegislationmay
facilitategender‐specificresearchof
cardiovasculardiseaseinorderto
understandtheuniquerisks,symptoms,and
treatmentthatwomenface.
7







HIPFRACTURE:DIDYOUKNOW?
1outof5
hipfracturepatientsdie
withinayearoftheirinjury.
11

1in4
adultswholivedindependentlybeforetheir
hipfracturehastostayinanursinghome
foratleastayearaftertheirinjury.
12


EXERCISEFORBONE&JOINT
HEALTH
Regularexercise,atleastthreetimesaweek,
canreducebonelossandtheriskoffallsand
bonefracturesinbothmenandwomen.
 Low‐impactweight‐bearingexercises,
suchaswalking,ridingastationarybike,
andtreadmillexercises

 Resistanceexercisesusinglightweights
andweightmachinesorswimmingto
helpmaintainbonemas
s

 Balance,flexibility,andstrength
activitiessuchastaichiandyoga

4
©Copyright2012HealthGrades,Inc.Allrightsreserved.

 Haveregulareyeexamstohelpeliminatepoorvisionasacauseoffalling
 Evaluateyourhomeenvironmentforhazardsthatmayincreaseyourriskoffalling
 Evaluateanymedicationsforpotentialsideeffectssuchasweaknessordizziness
 Haveregularcheckupsthatincludemonitoringsignsofan
emia(lowredbloodcelllevels),
whichcancauselightheadednessordizziness
 Wearsensibleshoestoreduce yourriskofstumblingorfalling
Formoreinformationonboneandjointhealth,visitSimpleStepstoKeepYourBonesStrong.
www.bettermedicine.com/topic/osteoporosis/simple‐steps‐to‐keep‐your‐bones‐strong


InformationIsPower
Forwomenthismeansnotonlyunderstandingtheuniquehealthriskswomenface,butalsothe
potentialimpacttheywillincurduetothequalityofcaretheyreceive.Womencanhelpprevent
unnecessaryhospitalizationsandpotentiallydecreasethepossibilityofcomplicationsbyworking
withtheirdoctortoknowandmodifytheirriskfactors.
Hospitalsandhealthcareprofessionalscanalsobetterunderstandthedifferencesbetween
womenandmenandensurethattheyaremeetingtheuniquehealthneedsofwomen.
The176HealthgradesWomen’sHealthExcellenceAwardrecipientshavesetanexampleof
superiorhospitalcaretothemothers,wives,sisters,anddau
ghtersintheircommunity.

HowHealthgradesDeterminedtheBest‐PerformingHospitals
forMaternityCareandGynecologicSurgery
Forbothmaternitycareandgynecologicsurgery,Healthgradesusedthreeyearsofdata,(2008
through2010)from19stateswherehospitalpatientoutcomesdataarepublicallyavailable.The
best‐performinghospitalsweredesignatedas5stars,average‐performinghospitalswere
designatedas3stars,andpoor‐performinghospitalsweredesignatedas1star.
Therewere224hospitalsthatwereratedwith5starsformaternitycare
.Formaternitycare,
hospitalswereevaluatedon:
 Vaginaldeliverymaternalcomplicationratesforsinglelivedeliveries(singlelivedeliveryis
apregnancywithasinglefetusaliveatbirth)
 C‐sectiondeliverymaternalcomplicationratesforsinglelivedeliveries
 Overallvolumeandvolumeoflowbirthweightdeliveries
 Risk‐adjustedinfantmortalityratesforsinglelivedeliveries
Therewere461hospitalsthatwereratedas5starsforgynecologicsurgery.Forgynecologic
surgery,Healthgradesevaluatedhospitalsonratesofin‐hospitalcomplications(s
uchas,post‐
operativeinfections,hemorrhages,respiratorycomplications,andcardiaccomplications).Forthis
analysis,Healthgradesevaluatedthefollowinginpatientgynecologicprocedures:

 Fistularepairsurgery
 Hysterectomy
 Surgeryforfallenbladdersorprolapse
 Surgeryforincontinence
 Surgeryonovariesandfallopiantubes
 Surgeryforvulvarcancer
Alistof5‐starratedhospitalsforbothofthesespe
cialtiescanbefoundinTables4and5.

19STATESSTUDIEDFOR
MATERNITYCAREAND
GYNECOLOGICSURGERY
Forbothmaternitycareandgynecologic
surgery,Healthgradesuseddatafrom19
stateswherehospitalpatientoutcomesdata
arepubliclyavailable.

 Arizona
 California
 Colorado
 Florida
 Iowa
 Maryland
 Massachusetts
 Nevada
 NewJersey
 NewYork
 NorthCarolina
 Oregon
 Pennsylvania

 RhodeIsland
 Texas
 Utah
 Virginia
 Was
hington
 Wisconsin





5
©Copyright2012HealthGrades,Inc.Allrightsreserved.

TheMostCommonIn‐HospitalComplications
From2008through2010,acrossthe19statesstudied,7.0%ofwomenundergoingsinglelive
deliveriesexperiencedanin‐hospitalcomplicationand9.2%ofwomenundergoinggynecologic
surgeryexperiencedanin‐hospitalcomplication.Themostcommonin‐hospitalcomplications
include:
VaginalDeliveries
 Severelacerations(3rdand4thdegree
perineallacerations)

 Hemorrhages(excessivebleeding)
C‐SectionDeliveries
 Hemorrhage
 Postpartuminfectionsandwound
complications
 Complicati onsrelatedtoanesthesia

GynecologicSurgery
 Accidentalpuncturesorlacerations
 Hemorrhages
 Digestivesystemcomplications(bowel
obstructions)
 Respiratorycomplications
MaternityCare
C‐SectionSurgicalTrends
AC‐section(caesareansection,cesareansection)isthesurgicaldeliveryofababybymakingan
incisionintotheabdominalcavityandthenanotherincisionintotheuterusitself.C‐sectionsare
performedwhenavaginaldeliveryputsthehealthofthemotherorthebabyatrisk,orattimes
whenapatienthashadapriorC‐section.
C‐SectionDeliveryRatesStablefortheFirstTimeinEightYears
HealthgradeslookedatthepercentageofC‐sectionsfrom2002through2010.In2002,theC‐
sectionratewas27%andby2009ithadincreasedto33%ofsinglelivedeliveries.Thedramatic
increaseinC‐sectionratesfrom2002‐2009hasbeenthesubjectofmuchcontroversy.
Thisrise
inC‐sectionshasbeenpartoftheimpetusforimportanthealthcareorganizations,such
asTheJointCommission,AgencyforHealthcareResearchandQuality,MarchofDimes,and
severalphysicianprofessionalorganizations,suchastheAmericanCollegeofObstetricsand
Gynecology,toendorsesafely
reducingC‐sectionratesin
certaintypesofpregnancies.
Thereisanationwidepushfrom
theseorganizationsandothersis
toeliminatethenon‐medically
indicatedinductionoflaboror
scheduledC‐sectionpriorto39
weeks;thisisonefactorthatmay
becontributingtotheC‐section

ratebeingstablesince2009at
33%.
DeliveryRatesbyState
Ofthe19statesstudied,Florida,
NewJerseyandTexashavethe
highestpercentageofC‐sections
comparedtovaginaldeliveries
(38.3%,37.8%and35.7%
respectively).Stateswiththe
lowestrateofC‐section
deliverieswereUtah,Wisconsin
andColorado(22.2%,25.1%and
26.9%respectively).Thesestates
werethesamerank
orderfor
2010asin2009.




















Table1.
C‐SectionDeliveryRatesbyState
(2008through2010)
%C‐section
Florida 38.3%
NewJersey 37.8%
Texas 35.7%
Virginia 35.4%
Nevada 35.1%
NewYork 33.8%
Maryland 33.6%
Massachusetts
32.4%
California 32.2%
Pennsylvania 31.5%
NorthCarolina 31.0%
RhodeIsland 30.6%
Washington 29.8%
Oregon 29.5%
Arizona 28.7%
Iowa 28.7%
Colorado 26.9%
Wisconsin 25.1%
Utah 22.2%
Total 32.9%

0% 10% 20% 30% 40%
Florida
NewJersey
Texas
Virginia
Nevada
NewYork
Maryland
Massachusetts
California
Pennsylvania
NorthCarolina
RhodeIsland
Washington
Oregon
Arizonia
Iowa
Colorado
Wisconsin
Utah
PercentageofC‐SectionComparedtoVaginal
DeliveriesbyState

6
©Copyright2012HealthGrades,Inc.Allrightsreserved.

WhatanExpectantMotherShouldKnowAboutC‐Sectionsand
WhentoDeliver
AC‐sectioncanbeanecessarysurgicalprocedurethatsavesthelifeofthemotherorbaby,such
aswhenababyisinfetaldistressoristoolargetopassthroughthepelvisandvagina.AC‐section

canbeplannedorunplanneddependingupontheneedsof
theexpectantmother.
AlthoughC‐sectionsaregenerallyconsideredsafe,itisimportanttounderstandthataC‐sectionis
stillamajorsurgicalprocedurethatincludesseriousriskstomothersandbabies,includingblood
clotsinthemotherandrespiratorycomplicationsinthenewborn.
Everypregnancyisunique,and
allthebenefitsandrisksofaC‐sectionversusavaginaldelivery
mustbeweighedcarefullytomakethebestpossiblechoiceforthemotherandherbaby.
Thetimingofwhentodeliver,througheitherascheduledC‐sectionormedicalinductionoflabor,
shouldbeathoughtfullymade
decisionincooperationwithyourdoctor.Evenafewweeksfrom
40weeksofgestationcanresultinrespiratorycomplicationsforthenewbornrequiringcostlyin‐
hospitalstays.Additionally,strongresearchsupportsthatthenewbornbrainisnotfully
developeduntil39weeksofgestation.
Expectantmothersareencouragedto
speaktotheirphysicianaboutnotonlytheindicationfora
scheduleddeliverybutwhatisthebesttimingforthisimportantevent.
GynecologicSurgery
Inall,Healthgradesevaluated930,743gynecologicsurgeriesfrom2008to2010inthe19states
studied.Ifallhospitalsperformedat5‐starquality,thentherewouldbe31,694fewer
complicationsobservedduringthesesurgeries.Hysterectomieswerethemostcommoninpatient
gynecologicprocedurewith734,394womenin19stateshavingtheprocedure.Ovarian
proceduresaccountedfor95,161surgeries.
Surprisingly,inpatienturinaryincontinenceproceduresweresomewhatuncommon,representing
only28,123oftheinpatientprocedures.Themostcommoncomplicationsarisingfrom
gynecologicsurgeryweredigestivecomplications,accidentalpunctureorlaceration,hemorrhage
(excessivebleeding),andpulmonarycomplications.
FewGynecologicProceduresPerformedforUrinaryIncontinence
Urinaryincontinenceisaninvoluntarylossofurinecontrolthatcanrangeinseverityfromasmall
amountofdribblingtoalargeuncontrollableflowofurine.Urinaryincontinenceisverycommon.

AccordingtotheNationalAssociationforContinence,approximately25millionadultAmericans
experiencetemporaryorchronicurinaryincontinence,andoneinfourwomenovertheageof18
experienceepisodesofleakingurineinvoluntarily
.
1
Althoughurinaryincontinenceisfairlycommon,therearerelativelyfewinpatientsurgical
proceduresperformedtocorrectthecondition.Healthgradesanalysisofgynecologicsurgery
showedthatin‐hospitalurinaryincontinencesurgeriesrepresentedonly3%oftheoverall
procedures.Manysurgicalproceduresperformedtocorrectincontinenceareperformedinan
outpatientsetting,whichmeansthatyouarenotactuallyadmittedtothehospital.
Thelowvolumeofin‐hospitalurinaryincontinencesurgeriesmayalsobeduetotheavailabilityof
lessinvasivechoicesfortreatingincontinenceandareluctanceforwomentodiscussthe
conditionwithhealthcareprovidersduetoembarrassmentorshame.
Unfortunately,manywomenmayacceptmildtomoderateincontinenceasanormalconsequence
ofchildbearingoragingdespitethefactthattherearetreatablecausesofurinaryincontinence
thatcanmakeamarkeddifferenceintheirqualityofliving.Itisimportanttonote,inSeptember
2011,theFDAconvenedaspecialcommitteeduetoconcernsovermeshplacementforstress
urinaryincontinence(SUI).ThemultidisciplinarycommitteeconcludedthatSUItreatmentwith
vaginalmeshplacementisbothsafeandeffective.
13


CHILDBIRTHANDOTHERRISKS
FORINCONTINENCE
Urinaryincontinencecanoccuratanyage,
butwomenolderthan50arethemost
likelyto
developtheconditionasthebody
startstoundergothechangesthat
menopausebrings.

Incontinencecanoccurduetophysical
changesresultingfromvaginaldelivery.
Incontinencecanalsobecausedby
pregnancyitselforbyinjurytothebladder
orurinarysystemthatcanoccurduringaC‐
sectionprocedure.Incontinence
canoccurin
theweeksandmonthsafterbirthoreven
decadeslater.
Otherfactors,someofwhichcanbe
controlled,thatincreasetheriskof
developingurinaryincontinenceinclude:
 Beingoverweightorobese
 Certaindiseases,suchasdiabetes,
Alzheimer’sdisease,multiplesclerosis,
andurinarytractinfections
 Chroniccough
thatcanweakenpelvic
floormuscles
 Deliriumduetoillnessormedications
 Disabilityorpoormobility,whichmakes
itdifficulttoreachthebathroom
quickly
 Excessiveweightgainwhilepregnant
 Hysterectomy
 Increasingage
 Pregnancywithababythatislarger
thanaverage
 Takingcertainmedications,suchas


diureticswhichincreasetheamountof
urine

DETERMININGTHECAUSEOF
INCONTINENCE
Manypeoplenevertelltheirphysicianthat
theyexperienceincontinence,andthis
resultsinprolongedandlargelyneedless
suffering.In70%ofcases,incontinencecan
becuredorsignificantlyimproved. Learn
aboutincontinenceandfindthecourageto
bringupthesubjectwithyourdoctor.
www.bettermedicine.com/topic/overactive‐
bladder/determining‐the‐cause‐of‐
your‐
incontinence


7
©Copyright2012HealthGrades,Inc.Allrightsreserved.

HospitalRecognizedas5‐StarinAllThreeHealthgradesWomen’sCareAreasin2012by
DesignatedMarketArea
Thefollowinghospitalshaveshownsuperiorperformanceforwomen’shealth,maternitycare,andgynecologicsurgeryfor2012.Thesehospitals
are5‐starhospitalsforallthreewomen’scareareasin2012:women’shealth,maternitycare,andgynecologicsurgery.
Someofthehospitalshavemultiplelocations.Inthesecases,resultsforall
locationswereusedintheanalysisandeachofthefacilitiesis
designatedasa5‐starhospital.
Table2.HospitalsRecognizedas5‐StarinAllThreeHealthgradesWomen’sCareAreas2012
DesignatedMarketArea

HospitalsRecognizedas5‐StarinAllThreeHealthgrades
Women’sCareAreas2012* City State
Washington,DC InovaAlexandriaHospital Alexandria VA
Miami‐Ft.Lauderdale,F
L
 KendallRegionalMedicalCenter Miami FL
WestPalmBeach,F
L
 Martin MemorialMedicalCenter Stuart FL
i
ncluding:MartinMemorialHospitalSouth Stuart FL
NewYork,NY Winthrop‐UniversityHospital Mineola NY
Lancaster,PA LancasterGeneralHospital Lancaster PA
Brownsville,TX HarlingenMedicalCenter Harlingen TX
Houston,TX MemorialHermannHealthcareSystem‐ Southwest Houston TX
MemorialHermannNorthwestHospital Houston TX
MemorialHermannSoutheastHospital Houston TX
MemorialHermannTheWoodlandsHospital TheWoodlands TX
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.



8
©Copyright2012HealthGrades,Inc.Allrightsreserved.

HealthgradesWomen’sHealthExcellenceAwardRecipients2012byDesignatedMarket 
Area
ThefollowinghospitalsarerecipientsoftheHealthgradesWomen’sHealthExcellenceAward*in2012.Someofthehospitalshavemultiple
locations.Inthesecases,resultsforalllocationswereusedintheanalysisand eachofthefacilitiesisdesignatedasarecipientoftheaward.
Table3.Women’sHealthExcellenceAwardRecipients2012

Designated
MarketArea Women’sHealthExcellenceAwardRecipients2012* City State
Birmingham,A
L
 PrincetonBaptistMedicalCenter Birmingham AL
Phoenix‐Prescott,
AZ
ArrowheadHospital Glendale AZ
 BannerBoswellMedicalCenter SunCity AZ
 BannerThunderbirdMedicalCenter Glendale AZ
 MayoClinicHospital Phoenix AZ
 ScottsdaleHealthcare‐OsbornMedicalCenter Scottsdale AZ
 ScottsdaleHealthcare‐SheaMedicalCenter Scottsdale AZ
 YavapaiRegionalMedicalCenter‐ West Prescott AZ
Chico‐Redding,CA MercyMedicalCenterRedding Redding CA
LosAngeles,CA Cedars‐SinaiMedicalCenter LosAngeles CA
 GarfieldMedicalCenter MontereyPark CA
 GlendaleMemorialHospitalandHealthCenter Glendale CA
 HoagMemorialHospitalPresbyterian NewportBeach CA
 HuntingtonMemorialHospital Pasadena CA
 PresbyterianIntercommunityHospital Whittier CA
 ProvidenceTarzanaMedicalCenter Tarzana CA
 SaddlebackMemorialMedicalCenter‐ LagunaHills LagunaHills CA
 including: SaddlebackMemorialMedicalCenterSanClemente SanClemente CA
 SaintJohn'sHealthCenter SantaMonica CA
 SaintVincentMedicalCenter LosAngeles CA
 St.John'sRegionalMedicalCenter Oxnard CA
Sacramento,CA MercyGeneralHospital Sacramento CA
 SutterGeneralHospital Sacramento CA
 including: SutterMemorialHospital Sacramento CA

SanDiego,CA ScrippsGreenHospital LaJolla CA
 ScrippsMemorialHospitalLaJolla LaJolla CA
 ScrippsMercyHospital SanDiego CA
 including: ScrippsMercyHospitalChulaVista ChulaVista CA
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

9
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Designated
MarketArea Women’sHealthExcellenceAwardRecipients2012* City State
SanFrancisco‐
Oakland,CA
AltaBatesSummitMedicalCenter‐ Summit Oakland CA
 SequoiaHospital RedwoodCity CA
 SutterMedicalCenterofSantaRosa SantaRosa CA
 WashingtonHospital Fremont CA
SantaBarbara,CA FrenchHospitalMedicalCenter SanLuisObispo CA
ColoradoSprings‐
Pueblo,CO
CenturaHealth‐PenroseSt.FrancisHealthServices ColoradoSprings CO
 including: SaintFrancisMedicalCenter ColoradoSprings CO
Denver,CO ExemplaSaintJosephHospital Denver CO
Hartford‐New
Haven,CT
HartfordHospital Hartford CT
 SaintMary'sHospital Waterbury CT
 Yale‐NewHavenHospital NewHaven CT
Salisbury,MD:
DEHospitals

BeebeMedicalCenter Lewes DE
Ft.Meyers,F
L
 LeeMemorialHospital FortMyers FL
 including: HealthParkMC/LeeMemorial FortMyers FL
Jacksonville,F
L
 FlaglerHospital SaintAugustine FL
Miami‐Ft.
Lauderdale,F
L

HolyCrossHospital FortLauderdale FL
 KendallRegionalMedicalCenter Miami FL
 MercyHospital‐ACampusofPlantationGeneral Miami FL
 MountSinaiMedicalCenter MiamiBeach FL
 including: MountSinaiMedicalCenterandMiamiHeartInstitute MiamiBeach FL
Orlando,F
L
 FloridaHospitalOrlando Orlando FL
 including: FloridaHospital‐Altamonte AltamonteSprings FL
  FloridaHospital‐Apopka Apopka FL
  CelebrationHealth Celebration FL
 OcalaRegionalMedicalCenter Ocala FL
 including: WestMarionCommunityHospital Ocala FL
PanamaCity,FL BayMedicalCenter PanamaCity FL
Tampa‐St.
Petersburg,F
L


LakelandRegionalMedicalCenter Lakeland FL
 SarasotaMemorialHospital Sarasota FL
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

10
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Designated
MarketArea Women’sHealthExcellenceAwardRecipients2012* City State
WestPalmBeach,F
L
 BethesdaMemorialHospital BoyntonBeach FL
 BocaRatonRegionalHospital BocaRaton FL
 DelrayMedicalCenter DelrayBeach FL
 MartinMemorialMedicalCenter Stuart FL
 including: MartinMemorialHospitalSouth Stuart FL
 PalmBeachGardensMedicalCenter PalmBeach
Gardens
FL
Atlanta,GA NortheastGeorgiaMedicalCenter Gainesville GA
 PiedmontHospital Atlanta GA
CedarRapids,IA SaintLuke’sHospital CedarRapids IA
Boise,ID SaintAlphonsusRegionalMedicalCenter Boise ID
Champaign‐
Springfield,I
L

CarleFoundationHospital Urbana IL
Chicago,I
L

 AdvocateChristHospitalandMedicalCenter OakLawn IL
 AdvocateGoodSamaritanHospital DownersGrove IL
 AdvocateGoodShepherdHospital Barrington IL
 EvanstonHospital Evanston IL
 including: GlenbrookHospital Glenview IL
  HighlandParkHospital HighlandPark IL
 PalosCommunityHospital PalosHeights IL
 ProvenaSaintJosephMedicalCenter Joliet IL
 ResurrectionMedicalCenter Chicago IL
 SaintJosephHospital Chicago IL
 SwedishCovenantHospital Chicago IL
Davenport,IA:
ILHospitals
TrinityMedicalCenter‐West RockIsland IL
 including: TrinityMedicalCenter‐ East Moline IL
Peoria,I
L
 MethodistMedicalCenterofIllinois Peoria IL
Chicago,IL:
INHospitals
CommunityHospital Munster IN
Ft.Wayne,IN ParkviewHospital FortWayne IN
 including:ParkviewNorthHospital FortWayne IN
Indianapolis,IN IndianaUniversityHealthMethodistHospital Indianapolis IN
 including: IndianaUniversityHealthUniversityHospital Indianapolis IN
 St.VincentIndianapolisHospital Indianapolis IN
 including: St.VincentWomen'sHospital Indianapolis IN
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

11

©Copyright2012HealthGrades,Inc.Allrightsreserved.

Designated
MarketArea Women’sHealthExcellenceAwardRecipients2012* City State
Lafayette,IN IndianaUniversityHealthArnettHospital Lafayette IN
Louisville,KY:
INHospitals
FloydMemorialHospitalandHealthServices NewAlbany IN
SouthBend,IN SaintJosephRegionalMedicalCenter Mishawaka IN
KansasCity,MO:
KSHospitals
ProvidenceMedicalCenter KansasCity KS
 UniversityofKansasHospital KansasCity KS
Cincinnati,OH:
KYHospitals
St.ElizabethEdgewood Edgewood KY
Evansville,IN:
KYHospitals
OwensboroMedicalHealthSystem Owensboro KY
Alexandria,LA CHRISTUSSaintFrancesCabriniHospital Alexandria LA
NewOrleans,LA OchsnerClinicFoundation NewOrleans LA
 including: OchsnerMedicalCenter‐ WestBankCampus Terrytown LA
Providence,RI:
MAHospitals
SouthcoastHospitalsGroup‐CharltonMemorial FallRiver MA
 including: SouthcoastHospitalsGroup‐ St.Luke'sHospital NewBedford MA
  SouthcoastHospitalsGroup‐ TobeyHospital Wareham MA
Baltimore,MD SaintJosephMedicalCenter Towson MD
 SinaiHospitalofBaltimore Baltimore MD
 UnionMemorialHospital Baltimore MD

Salisbury,MD PeninsulaRegionalMedicalCenter Salisbury MD
Washington,DC:
MDHospitals
SuburbanHospital Bethesda MD
 WesternMarylandRegionalMedicalCenter Cumberland MD
Detroit,MI BeaumontHospital‐Troy Troy MI
 CrittentonHospitalMedicalCenter Rochester MI
 MountClemensRegionalMedicalCenter MountClemens MI
 ProvidenceHospital Southfield MI
 St.JosephMercyOakland Pontiac MI
Flint,MI GenesysRegionalMedicalCenter GrandBlanc MI
Lansing,MI AllegianceHealth Jackson MI
TraverseCity,MI MunsonMedicalCenter TraverseCity MI
Duluth,MN SaintLuke’sHospital Duluth MN
Minneapolis‐St.
Paul,MN
FairviewSouthdaleHospital Edina MN
 NorthMemorial Robbinsdale MN
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

12
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Designated
MarketArea Women’sHealthExcellenceAwardRecipients2012* City State
Rochester,MN MayoClinicSaintMary’sHospital Rochester MN
Columbia‐Jefferson
City,MO
BooneHospitalCenter Columbia MO
Springfield,MO SkaggsRegionalMedicalCenter Branson MO

St.Joseph,MO HeartlandRegionalMedicalCenter SaintJoseph MO
St.Louis,MO MissouriBaptistMedicalCenter SaintLouis MO
 SSMSaintMary’sHealthCenter RichmondHeights MO
 SSMSt.ClareHealthCenter Fenton MO
 St.Luke'sHospital Chesterfield MO
GreatFalls,MT BenefisHealthSystem GreatFalls MT
Charlotte,NC GastonMemorialHospital Gastonia NC
Greenville,SC:
NCHospitals
MissionHospitals Asheville NC
Bismarck,ND MedcenterOne Bismarck ND
Fargo,ND AltruHospital GrandForks ND
Lincoln,NE BryanLGHMedicalCenterEast Lincoln NE
 including: BryanLGHMedicalCenterWest Lincoln NE
NewYork,NY:
NJHospitals
HackensackUniversityMedicalCenter Hackensack NJ
 MorristownMedicalCenter Morristown NJ
 ValleyHospital Ridgewood NJ
Philadelphia,PA:
NJHospitals
OurLadyofLourdesMedicalCenter Camden NJ
Albany,NY AlbanyMedicalCenterHospital Albany NY
 SaintPeter'sHospital Albany NY
NewYork,NY BonSecoursGoodSamaritanHospitalofSuffern Suffern NY
 MaimonidesMedicalCenter Brooklyn NY
 NewYork‐PresbyterianHospital/WeillCornell NewYork NY
 including: NewYork‐PresbyterianHospital/AllenPavillion NewYork NY
  NewYork‐PresbyterianHospital/ColumbiaUniversity
 MedicalCenter

NewYork NY
 VassarBrothersMedicalCenter Poughkeepsie NY
 Winthrop‐UniversityHospital Mineola NY
Charleston,WV:
OHHospitals
SouthernOhioMedicalCenter Portsmouth OH
Cincinnati,OH BethesdaNorthHospital Cincinnati OH
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

13
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Designated
MarketArea Women’sHealthExcellenceAwardRecipients2012* City State
Cleveland,OH AkronGeneralMedicalCenter Akron OH
 AultmanHospital Canton OH
 EMHRegionalMedicalCenter Elyria OH
 FairviewHospital Cleveland OH
 HillcrestHospital MayfieldHeights OH
 MercyMedicalCenter Canton OH
 ParmaCommunityGeneralHospital Parma OH
 SouthwestGeneralHealthCenter Middleburg
Heights
OH
Columbus,OH FairfieldMedicalCenter Lancaster OH
Dayton,OH GrandviewMedicalCenter Dayton OH
Toledo,OH ProMedicaToledoHospital Toledo OH
Youngstown,OH NorthsideMedicalCenter Youngstown OH
 SaintElizabethHealthCenter Youngstown OH
Zanesville,OH GenesisHealthcareSystem Zanesville OH

Tulsa,OK SaintFrancisHospital Tulsa OK
Eugene,OR SacredHeartMedicalCenteratRiverbend Springfield OR
 including: SacredHeartMedicalCenter‐ UniversityDistrict Eugene OR
Medford,OR RogueValleyMedicalCenter Medford OR
Erie,PA HamotMedicalCenter Erie PA
 SaintVincentHealthCenter Erie PA
Johnstown‐Altoona,
PA
ConemaughMemorialMedicalCenter Johnstown PA
 including: MemorialMedicalCenter‐ Lee Johnstown PA
Lancaster,PA LancasterGeneralHospital Lancaster PA
Philadelphia,PA BrynMawrHospital BrynMawr PA
 EinsteinMedicalCenter‐Philadelphia Philadelphia PA
 including: EinsteinMedicalCenter‐ Germantown Philadelphia PA
 LankenauHospital Wynnewood PA
 PennPresbyterianMedicalCenter Philadelphia PA
Pittsburgh,PA SaintClairHospital Pittsburgh PA
 TheWesternPennsylvaniaHospital‐ ForbesRegionalCampus Monroeville PA
WilkesBarre‐
Scranton,PA
CommunityMedicalCenter Scranton PA
 RegionalHospitalofScranton Scranton PA
 WilliamsportRegionalMedicalCenter Williamsport PA
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

14
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Designated
MarketArea Women’sHealthExcellenceAwardRecipients2012* City State

Greenville,SC AnmedHealth Anderson SC
 SpartanburgRegionalMedicalCenter Spartanburg SC
Chattanooga,TN MemorialHealthcareSystem Chattanooga TN
Nashville,TN CookevilleRegionalMedicalCenter Cookeville TN
Brownsville,TX HarlingenMedicalCenter Harlingen TX
 SouthTexasHealth‐EdinburgRegionalMedicalCenter Edinburg TX
 including: McAllenMedicalCenter McAllen TX
  SouthTexasHealth‐ McAllenMedicalCenter/Heart
 Hospital
McAllen TX
Houston,TX MemorialHermannHealthcareSystem‐ Southwest Houston TX
 including: MemorialHermannNorthwestHospital Houston TX
  MemorialHermannSoutheastHospital Houston TX
  MemorialHermannTheWoodlandsHospital Shenandoah TX
 TheMethodistHospital Houston TX
 including: DiagnosticCenterHospital Houston TX
 TomballRegionalMedicalCenter Tomball TX
Lubbock,TX LubbockHeartHospital Lubbock TX
SaltLakeCity,UT IntermountainMedicalCenter Murray UT
 St.Mark'sHospital SaltLakeCity UT
Richmond,VA BonSecoursMemorialRegionalMedicalCenter Mechanicsville VA
 HenricoDoctors'Hospital Richmond VA
 including: ParhamDoctors'Hospital Richmond VA
  RetreatDoctors'Hospital Richmond VA
Washington,DC:
VAHospitals
InovaAlexandriaHospital Alexandria VA
Seattle‐Tacoma,
WA
PeaceHealthSt.JosephMedicalCenter Bellingham WA

GreenBay‐
Appleton,WI
AuroraBayCareMedicalCenter GreenBay WI
 BellinMemorialHospital GreenBay WI
LaCrosse‐Eau
Claire,WI
GundersenLutheranMedicalCenter LaCrosse WI
Milwaukee,WI AuroraSaintLuke’sMedicalCenter Milwaukee WI
 including: SaintLuke’sMedicalCenter Cudahy WI
  AuroraSinaiMedicalCenter Milwaukee WI
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.


15
©Copyright2012HealthGrades,Inc.Allrightsreserved.

HealthgradesMaternityCare5‐StarHospitalsandMaternityCareExcellenceAward
Recipients2012byDesignatedMarketArea
Thefollowinghospitalsare5‐starratedinMaternityCare.AlsoindicatedarerecipientsoftheHealthgradesMaternityCareExcellenceAward*in
2012,indicatingthattheywereamongthebest10%ofhospitalsmeetingminimumvolumerequirements.Someofthehospitalshavemultiple
locations.Inthesecases,resultsforalllocationswereusedintheanalysisandeachofthefacilitiesisdesignatedasa5‐starhospitalora
recipientoftheawardasindicated.
Table4.MaternityCare5‐StarHospitalsandMaternityCareExcellenceAwardRecipients2012
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…
Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
Phoenix‐Prescott,AZ x ArrowheadHospital Glendale AZ

 x BannerBaywoodMedicalCenter Mesa AZ
BannerEstrellaMedicalCenter Phoenix AZ
BannerGatewayMedicalCenter Gilbert AZ
Bakersfield,CABakersfieldMemorialHospital Bakersfield CA
Fresno,CAClovisCommunityMedicalCenter Clovis CA
 x MaderaCommunityHospital Madera CA
 x SaintAgnesMedicalCenter Fresno CA
 x TulareRegionalMedicalCenter Tulare CA
LosAngeles,CA x AntelopeValleyHospital Lancaster CA
BellflowerMedicalCenter Bellflower CA
 x CitrusValleyMedicalCenter‐ Inter‐CommunityCampus Covina CA

i
ncluding: CitrusValleyMedicalCenter‐ QueenoftheValley WestCovina CA
 x CoastalCommunitiesHospital SantaAna CA
 x CoronaRegionalMedicalCenter Corona CA
DowneyRegionalMedicalCenter Downey CA
 x EastLosAngelesDoctorsHospital LosAngeles CA
EastValleyHospitalMedicalCenter Glendora CA
FountainValleyRegionalHospitalandMedicalCenter FountainValley CA
 x GarfieldMedicalCenter MontereyPark CA
GlendaleMemorialHospitalandHealthCenter Glendale CA
 x GoodSamaritanHospital LosAngeles CA
GreaterElMonteCommunityHospital SouthElMonte CA
HuntingtonMemorialHospital Pasadena CA
KaiserFoundationHospital‐ MorenoValley MorenoValley CA
KaiserPermanenteDowneyMedicalCenter Downey CA
LosAngelesCommunityHospital LosAngeles CA

i

ncluding: NorwalkCommunityHospital Norwalk CA
 x MethodistHospitalofSouthernCalifornia Arcadia CA
 x MillerChildren'sHospital LongBeach CA
 x MontereyParkHospital MontereyPark CA

16
©Copyright2012HealthGrades,Inc.Allrightsreserved.

*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…
Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
LosAngeles,CA
Continued
 NorthridgeHospitalMedicalCenter Northridge CA
OrangeCoastMemorialMedicalCenter FountainValley CA
PacificAllianceMedicalCenter LosAngeles CA
 x PacificHospitalofLongBeach LongBeach CA
ParkviewCommunityHospitalMedicalCenter Riverside CA
 x PomonaValleyHospitalMedicalCenter Pomona CA
ProvidenceSaintJosephMedicalCenter Burbank CA
 x ProvidenceTarzanaMedicalCenter Tarzana CA
RiversideCommunityHospital Riverside CA
RiversideCountyRegionalMedicalCenter MorenoValley CA
 x SaintFrancisMedicalCenter Lynwood CA
 x SaintMaryMedicalCenter LongBeach CA
SanAntonioCommunityHospital Upland CA
 x St.BernardineMedicalCenter SanBernardino CA

 x ValleyPresbyterianHospital VanNuys CA
 x VictorValleyCommunityHospital Victorville CA
WestHillsHospitalandMedicalCenter WestHills CA
 x WesternMedicalCenterAnaheim Anaheim CA
 x WesternMedicalCenterSantaAna SantaAna CA
 x WhittierHospitalMedicalCenter Whittier CA
Sacramento,CA x EmanuelMedicalCenter Turlock CA
 x MercyGeneralHospital Sacramento CA
 x MercySanJuanMedicalCenter Carmichael CA
 x SutterRosevilleMedicalCenter Roseville CA
SanDiego,CA x PomeradoHospital Poway CA
ScrippsMemorialHospitalLaJolla LaJolla CA
SanFrancisco‐
Oakland,CA
x O'ConnorHospital SanJose CA
 x SaintRoseHospital Hayward CA
 x SutterDeltaMedicalCenter Antioch CA
SantaBarbara,CA x SierraVistaRegionalMedicalCenter SanLuisObispo CA
Yuma,AZ:
CAHospitals
x PioneersMemorialHospital Brawley CA
Ft.Meyers,F
L
 x GulfCoastMedicalCenter FortMyers FL
Miami‐Ft.Lauderdale,
FL
x CoralSpringsMedicalCenter CoralSprings FL
 x HialeahHospital Hialeah FL
 x KendallRegionalMedicalCenter Miami FL
 x MountSinaiMedicalCenter MiamiBeach FL


i
ncluding: MountSinaiMedicalCenterandMiamiHeartInstitute MiamiBeach FL
 x PalmettoGeneralHospital Hialeah FL

17
©Copyright2012HealthGrades,Inc.Allrightsreserved.

*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
Orlando,F
L
FloridaHospitalDeland Deland FL
 x HalifaxHealth‐MedicalCenterofDaytonaBeach DaytonaBeach FL

i
ncluding: AtlanticMedicalCenter DaytonaBeach FL
 HalifaxHealth‐ MedicalCenterofPortOrange PortOrange FL
HealthCentral Ocoee FL
MunroeRegionalMedicalCenter Ocala FL
 x OsceolaRegionalMedicalCenter Kissimmee FL
PanamaCity,FL x JacksonHospital Marianna FL
Tampa‐St.Petersburg,
FL
 BrooksvilleRegionalHospital Brooksville FL


i
ncluding: SpringHillRegionalHospital SpringHill FL
 x HeartofFloridaRegionalMedicalCenter Davenport FL
 x LakelandRegionalMedicalCenter Lakeland FL
ManateeMemorialHospital Bradenton FL
MedicalCenterofTrinity Trinity FL
SaintPetersburgGeneralHospital SaintPetersburg FL
 x SarasotaMemorialHospital Sarasota FL
 x WinterHavenHospital WinterHaven FL

i
ncluding: RegencyMedicalCenter WinterHaven FL
WestPalmBeach,F
L
 x BethesdaMemorialHospital BoyntonBeach FL
 x BocaRatonRegionalHospital BocaRaton FL
MartinMemorialMedicalCenter Stuart FL

i
ncluding: MartinMemorialHospitalSouth Stuart FL
 x WellingtonRegionalMedicalCenter Wellington FL
 x WestBocaMedicalCenter BocaRaton FL
CedarRapids,IA x CovenantMedicalCenter Waterloo IA
Davenport,IA x GenesisMedicalCenter‐ Davenport Davenport IA
DesMoines,IA x MercyMedicalCenter‐ DesMoines DesMoines IA

i
ncluding: MercyMedicalCenter‐ WestLakes WestDesMoines IA
Boston,MAEmersonHospital Concord MA

Providence,RI:
MAHospitals
 SouthcoastHospitalsGroup‐ CharltonMemorial FallRiver MA

i
ncluding: SouthcoastHospitalsGroup‐ St.Luke'sHospital NewBedford MA
 SouthcoastHospitalsGroup‐ TobeyHospital Wareham MA
Springfield,MA x BaystateMedicalCenter Springfield MA
Washington,DC:
MDHospitals
 CalvertMemorialHospital PrinceFrederick MD
 x HolyCrossHospital SilverSpring MD
WashingtonAdventistHospital TakomaPark MD

18
©Copyright2012HealthGrades,Inc.Allrightsreserved.

*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
Charlotte,NC x CarolinasMedicalCenter‐ Northeast Concord NC
 x CatawbaValleyMedicalCenter Hickory NC
 x PresbyterianHospitalMatthews Matthews NC
Greensboro,NCHughChathamMemorialHospital Elkin NC
Greenville,NC x CarolinaEastMedicalCenter NewBern NC
 x OnslowMemorialHospital Jacksonville NC

Norfolk,VA:
NCHospitals
x Roanoke‐ChowanHospital Ahoskie NC
Raleigh‐Durham,NC x DurhamRegionalHospital Durham NC
 x WilsonMedicalCenter Wilson NC
NewYork,NY:
NJHospitals
x ChristHospital JerseyCity NJ
 x ClaraMaassMedicalCenter Belleville NJ
 x EnglewoodHospital&MedicalCenter Englewood NJ
HackettstownRegionalMedicalCenter Hackettstown NJ
HobokenUniversityMedicalCenter Hoboken NJ
 x HolyNameMedicalCenter Teaneck NJ
 x KimballMedicalCenter Lakewood NJ
 x SaintBarnabasMedicalCenter Livingston NJ
 x SaintJoseph'sRegionalMedicalCenter Paterson NJ

i
ncluding: SaintJoseph'sChildrenHospital Pate rson NJ
 SaintJoseph'sWayneHospital Wayne NJ
 x SaintPeter'sUniversityHospital NewBrunswick NJ

i
ncluding: TheChildren'sHospitalatSaintPeter'sUniversityHospital NewBrunswick NJ
 x TrinitasReg ionalMedicalCenter Elizabeth NJ
Philadelphia,PA:
NJHospitals
x AtlantiCareRegionalMedicalCenter‐ AtlanticCity AtlanticCity NJ

i

ncluding: AtlantiCareRegionalMedicalCenter‐ Mainland Pomona NJ
 x RobertWoodJohnson UniversityHospitalHamilton Hamilton NJ
 x UniversityMedicalCenteratPrinceton Princeton NJ
LasVegas,NVMountainviewHospital LasVegas NV
Albany,NYEllisHospital Schenectady NY

i
ncluding: BellevueWoman'sHospital Niskayuna NY
 EllisHospital‐ McClellan Schenectady NY
Buffalo,NYJonesMemorialHospital Wellsville NY
 x MercyHospital Buffalo NY

19
©Copyright2012HealthGrades,Inc.Allrightsreserved.

*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
NewYork,NY x BonSecoursGoodSamaritanHospitalofSuffern Suffern NY
Bronx‐LebanonHospitalCenter Bronx NY

i
ncluding: Bronx‐Lebanon‐‐ConcourseDivision Bronx NY
 x CatskillRegionalMedicalCenter Harris NY
 x ConeyIslandHospital Brooklyn NY
 x FlushingHospitalMedicalCenter Flushing NY

 x ForestHillsHospital ForestHills NY
 x HuntingtonHospital Huntington NY
 x LawrenceHospitalCenter Bronxville NY
 x NassauUniversityMedicalCenter EastMeadow NY
 x NewYorkDowntownHospital NewYork NY
 x NewYorkHospitalMedicalCenterofQueens Flushing NY
 x NewYorkMethodistHospital Brooklyn NY
 x NorthShoreUniversityHospital Manhasset NY

i
ncluding: NorthShoreUniversityHospitalSyosset Syosset NY
 x NyackHospital Nyack NY
 x NYULangoneMedicalCenter NewYork NY
 x PlainviewHospital Plainview NY
 x RichmondUniversityMedicalCenter StatenIsland NY
 x SaintCatherineofSienaMedicalCenter Smithtown NY
 x SaintCharlesHospital PortJefferson NY
 x SaintJohn'sRiversideHospital‐ AndrusPavilion Yonkers NY

i
ncluding: CommunityHospitalatDobbsFerry DobbsFerry NY
 x SoundShoreMedicalCenterofWestchester NewRochelle NY
 x SouthsideHospital BayShore NY
 x St.Luke'sCornwallHospital Newburgh NY
VassarBrothersMedicalCenter Poughkeepsie NY
WhitePlainsHospitalCenter WhitePlains NY
Winthrop‐UniversityHospital Mineola NY
Rochester,NYNewark‐WayneCommunityHospital Newark NY
Buf
f

alo,NY:
PAHospitals
x BradfordRegionalMedicalCenter Bradford PA
Johnstown‐Altoona,
PA
x ConemaughMemorialMedicalCenter Johnstown PA

i
ncluding: MemorialMedicalCenter‐ Lee Johnstown PA
DuboisRegionalMedicalCenter DuBois PA
Lancaster,PALancasterGeneralHospital Lancaster PA
PinnacleHealthSystem Harrisburg PA

20
©Copyright2012HealthGrades,Inc.Allrightsreserved.

*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
Philadelphia,PA x AbingtonMemorialHospital Abington PA

i
ncluding: AlleghenyUniversityHospitals‐ Bucks Warminster PA
 x ChesterCountyHospital WestChester PA
 x Crozer‐ChesterMedicalCenter Chester PA


i
ncluding: SpringfieldHospital Springfield PA
 x PottstownMemorialMedicalCenter Pottstown PA
RiddleMemorialHospital Media PA
Pittsburgh,PA x HeritageValleySewickley Sewickley PA
WestmorelandHospital Greensburg PA
WilkesBarre‐
Scranton,PA
x MosesTaylorHospital Scranton PA
Providence,RI x KentHospital Warwick RI
Austin,TX x St.David'sMedicalCenter Austin TX

i
ncluding: St.David'sGeorgetownHospital Georgetown TX
 x St.David'sSouth AustinMedicalCenter Austin TX
Beaumont‐Port
Arthur,TX
x BaptistBeaumontHospital Beaumont TX
 x MemorialHermannBaptistOrangeHospital Orange TX
Brownsville,TX x HarlingenMedicalCenter Harlingen TX
 x KnappMedicalCenter Weslaco TX
ValleyBaptistMedicalCenter Harlingen TX
 x ValleyBaptistMedicalCenter‐ Brownsville Brownsville TX
 x ValleyRegionalMedicalCenter Brownsville TX
Dallas‐Ft.Worth,TXEastTexasMedicalCenterAthens Athens TX
MedicalCenterofArlington Arlington TX
MethodistCharltonMedicalCenter Dallas TX
 x TexasHealthPresbyterianHospitalAllen Allen TX
TexasHealthPresbyterianHospitalDenton Denton TX
ElPaso,TXLasPalmasMedicalCenter ElPaso TX


i
ncluding: DelSolMedicalCenter ElPaso TX
 x SierraMedicalCenter ElPaso TX
SierraProvidenceEastMedicalCenter ElPaso TX

21
©Copyright2012HealthGrades,Inc.Allrightsreserved.

*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…
Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
Houston,TX x Angleton‐DanburyMedicalCenter Angleton TX
 x CHRISTUSSaintCatherineHospital Katy TX
ClevelandRegionalMedicalCenter Cleveland TX
 x CypressFairbanksMedicalCenter Houston TX
 x DoctorsHospitalTidwell Houston TX
 x HoustonNorthwestMedicalCenter Houston TX
 x KingwoodMedical Center Kingwood TX
 x MemorialHermannHealthcareSystem‐ Southwest Houston TX

i
ncluding: MemorialHermannNorthwestHospital Houston TX
 MemorialHermannSoutheastHospital Houston TX
 MemorialHermannTheWoodlandsHospital Shenandoah TX
MemorialHermannSugarLandHospital SugarLand TX
 x MethodistSugarLandHospital SugarLand TX

 x MethodistWillowbrookHospital Houston TX
 x OakbendMedicalCenter Richmond TX
St.Luke'sSugarLandHospital SugarLand TX
St.Luke'sTheWoodlandsHospital TheWoodlands TX
Laredo,TXDoctorsHospitalofLaredo Laredo TX
 x LaredoMedicalCenter Laredo TX
SanAngelo,TX x SanAngeloCommunityMedicalCenter SanAngelo TX
ShannonMedicalCenter SanAngelo TX
including ShannonMedicalCenter‐ St.John's SanAngelo TX
SanAntonio,TX x MethodistHospital SanAntonio TX

i
ncluding: NortheastMethodistHospital LiveOak TX
 MethodistSpecialtyandTransplantHospital SanAntonio TX
 MetropolitanMethodistHospital SanAntonio TX
 x ValVerdeRegionalMedicalCenter DelRio TX
Shreveport,LA:
TXHospitals
x WadleyRegionalMedicalCenter Texarkana TX
Tyler,TX x GoodShepherdMedicalCenter Longview TX
Victoria,TXDetarHospitalNavarro Victoria TX

i
ncluding: DetarHospitalNorth Victoria TX
Waco,TXCollegeStationMedicalCenter CollegeStation TX
KingsDaughtersHospital Temple TX
SaltLakeCity,UTDavisHospital&MedicalCenter Layton UT
DixieRegionalMedicalCenter SaintGeorge UT
 x McKay‐DeeHospitalCenter Ogden UT
 x MountainViewHospital Payson UT

 x OgdenRegionalMedicalCenter Ogden UT
UtahValleyRegionalMedicalCenter Provo UT

22
©Copyright2012HealthGrades,Inc.Allrightsreserved.

*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.

Designated
MarketArea
Award
Recipients
MaternityCare5‐StarHospitals2012* City State
Norfolk,VABonSecours‐MaryviewMedicalCenter Portsmouth VA
ChesapeakeRegionalMedicalCenter Chesapeake VA
 x SentaraLeighHospital Norfolk VA
 x SentaraNorfolkGeneralHospital Norfolk  VA
 x SentaraVirginiaBeachGeneralHospital VirginiaBeach VA
Roanoke,VA x LynchburgGeneralHospital Lynchburg VA
Washington,DC:
VAHospitals
x InovaAlexandriaHospital Alexandria VA
InovaFairOaksHospital Fairfax VA
 x RestonHospitalCenter Reston VA
Seattle‐Tacoma,WAEvergreenHospitalMedicalCenter Kirkland WA
 x SaintJosephMedicalCenter Tacoma WA
Milwaukee,WI x AuroraMedicalCenter‐ Kenosha Kenosha WI
 x WheatonFranciscan‐ SaintJoseph Milwaukee WI

i

ncluding: TheWisconsinHeartHospital Milwaukee WI
Wausau,WI x AspirusWausauHospital Wausau WI

23
©Copyright2012HealthGrades,Inc.Allrightsreserved.

HealthgradesGynecologicSurgery5‐StarHospitalsandGynecolo gicSurgeryExcellence
AwardRecipients2012byDesignatedMarketArea
Thefollowinghospitalsare5‐starratedinGynecologicSurgery.AlsoindicatedarerecipientsoftheHealthgradesGynecologicSurgeryExcellence
Award*in2012,indicatingthattheywereamongthebest10%ofhospitalsmeetingminimumvolumerequirements.Someofthehospitalshave
multiplelocations.Inthesecases,resultsforalllocationswereusedintheanalysisandeachofthefacilitiesisdesignatedasa5‐starhospitalora
recipientoftheawardasindicated.
Table5.GynecologicSurgery5‐StarHospitalsandGynecologicSurgeryExcellenceAwardRecipients2012
Designated
MarketArea
Award
Recipients
GynecologicSurgery5‐StarHospitals2012* City State
Phoenix‐Prescott,AZBannerThunderbirdMedicalCenter Glendale AZ
VerdeValleyMedicalCenter Cottonwood AZ
Bakersfield,CA x BakersfieldMemorialHospital Bakersfield CA
 x SanJoaquinCommunityHospital Bakersfield CA
Chico‐Redding,CAFeatherRiverHospital Paradise CA
SaintElizabethCommunityHospital RedBluf
f
 CA
Eureka,CASaintJosephHospital Eureka CA
Fresno,CAAdventistMedicalCenter‐ Hanford Hanford CA
 x ClovisCommunityMedicalCenter Clovis CA
 x CommunityRegionalMedicalCenter Fresno CA


i
ncluding: CommunityHealthCenter‐ Cedar Fresno CA
 x KaweahDeltaMedicalCenter Visalia CA
 x MaderaCommunityHospital Madera CA
SierraKingsDistrictHospital Reedley CA
TulareRegionalMedicalCenter Tulare CA
LosAngeles,CA x AHMCAnaheimRegionalMedicalCenter Anaheim CA
 x ArrowheadRegionalMedicalCenter Colton CA
 x BellflowerMedi calCenter Bellflower CA
BrotmanMedicalCenter CulverCity CA
 x CitrusValleyMedicalCenter‐ Inter‐CommunityCampus Covina CA

i
ncluding: CitrusValleyMedicalCenter‐ QueenoftheValley WestCovina CA
CoastalCommunitiesHospital SantaAna CA
 x CommunityHospitalofHuntingtonPark HuntingtonPark CA
 x CoronaRegionalMedicalCenter Corona CA
DoctorsHospitalofWestCovina WestCovina CA
 x DowneyRegionalMedicalCenter Downey CA
EastLosAngelesDoctorsHospital LosAngeles CA
 x FoothillPresbyterianHospital Glendora CA
 x FountainValleyRe gionalHospitalandMedicalCenter FountainValley CA
GlendaleAdventistMedicalCenter Glendale CA
 x GoodSamaritanHospital LosAngeles CA
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

24
©Copyright2012HealthGrades,Inc.Allrightsreserved.


Designated
MarketArea
Award
Recipients
GynecologicSurgery5‐StarHospitals2012* City State
LosAngeles,CA
continued
 GreaterElMonteCommunityHospital SouthElMonte CA
Harbor‐UCLAMedicalCenter Torrance CA
HemetValleyMedicalCenter Hemet CA
HenryMayoNewhallMemorialHospital Valencia CA
KaiserPermanenteDowneyMedicalCenter Downey CA
KaiserPermanenteFontanaMedicalCenter Fontana CA
 x KaiserPermanenteRiversideMedicalCenter Riverside CA
 x KaiserPermanenteSouthBayMedicalCenter HarborCity CA
 x LAC+USCMedicalCenter LosAngeles CA
 x LongBeachMemorialMedicalCenter LongBeach CA
LosAlamitosMedicalCenter LosAlamitos CA
LosAngelesCommunityHospital LosAngeles CA

i
ncluding: NorwalkCommunityHospital Norwalk CA
 x MemorialHospitalofGardena Gardena CA
MontereyParkHospital MontereyPark CA
 x OrangeCoastMemorialMedicalCenter FountainValley CA
PacificHospitalofLongBeach LongBeach CA
PacificaHospitaloftheValley SunValley CA
 x PalmdaleRegionalMedicalCenter Palmdale CA
ParkviewCommunityHospitalMedicalCenter Riverside CA
 x PomonaValleyHospitalMedicalCenter Pomona CA

ProvidenceLittleCompanyofMaryMedicalCenterSanPedro SanPedro CA
 x ProvidenceLittleCompanyofMaryMedicalCenterTorrance Torrance CA
ProvidenceSaintJosephMedicalCenter Burbank CA
 x RedlandsCommunityHospital Redlands CA
RidgecrestRegionalHospital Ridgecrest CA
RiversideCommunityHospital Riverside CA
 x RiversideCountyRegionalMedicalCenter MorenoValley CA
SaintMaryMedicalCenter LongBeach CA
 x SanAntonioCommunityHospital Upland CA
SimiValleyHospital SimiValley CA
 x SouthwestHealthcareSystem‐ RanchoSpringsMedicalCenter Murrieta CA

i
ncluding: SouthwestHealthcareSystem‐ InlandValleyMedical
Center
Wildomar CA
 x St.BernardineMedicalCenter SanBernardino CA
St.JudeMedicalCenter Fullerton CA
TempleCommunityHospital LosAngeles CA
 x TorranceMemorialMedicalCenter Torrance CA
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…

25
©Copyright2012HealthGrades,Inc.Allrightsreserved.

Designated
MarketArea
Award
Recipients
GynecologicSurgery5‐StarHospitals2012* City State

LosAngeles,CA
continued
 Tri‐CityRegionalMedicalCenter HawaiianGardens CA
ValleyPresbyterianHospital VanNuys CA
VerdugoHillsHospital Glendale CA
 x VictorValleyCommunityHospital Victorville CA
WestHillsHospitalandMedicalCenter WestHills CA
WhittierHospitalMedicalCenter Whittier CA
Medford,OR:
CAHospitals
 FairchildMedicalCenter Yreka CA
Monterey‐Salinas,
CA
 HazelHawkinsMemorialHospital Hollister CA
PalmSprings,CADesertRegionalMedicalCenter PalmSprings CA
EisenhowerMedicalCenter RanchoMirage CA
Sacramento,CAEmanuelMedicalCenter Turlock CA
KaiserPermanenteSacramentoMedicalCenter Sacramento CA
KaiserPermanenteSouthSacramentoMedicalCenter Sacramento CA
KaiserPermantenteMantecaMedicalCenter Manteca CA
 x LodiMemorialHospital Lodi CA
OakValleyHospital Oakdale CA
PlumasDistrictHospital Quincy CA
RideoutMemorialHospital Marysville CA

i
ncluding: FremontMedicalCenter YubaCity CA
 x SaintJoseph’sMedicalCenterofStockton Stockton CA
StanislausSurgicalHospital Modesto CA
 x SutterAmadorHospital Jackson CA

SutterSurgicalHospital‐ NorthValley YubaCity CA
SanDiego,CA x PomeradoHospital Poway CA
ScrippsGreenHospital LaJolla CA
SharpGrossmontHospital LaMesa CA
SanFrancisco‐
Oakland,CA
 AlamedaCountyMedicalCenter Oakland CA
 x CaliforniaPacificMedicalCenter‐ Pacific SanFrancisco CA

i
ncluding: CaliforniaPacificMedicalCenter‐ California SanFrancisco CA
 x KaiserPermanenteSantaRosaMedicalCenter SantaRosa CA
KaiserPermanenteSouthSanFranciscoMedicalCenter SouthSanFrancisco CA
MenloParkSurgicalHospital MenloPark CA
O'ConnorHospital SanJose CA
SaintMary'sMedicalCenter SanFrancisco CA
SanMateoMedicalCenter SanMateo CA
SonomaValleyHospital Sonoma CA
SutterLakesideHospital Lakeport CA
SutterMedicalCenterofSantaRosa SantaRosa CA
UkiahValleyMedicalCenter Ukiah CA
*DistinctioncannotbeusedwithoutaLicensingAgreementfromHealthGrades,Inc.Continued…