High Mortality Rate at 8 Hospitals Cited : Health: The California facilities are among 102 in U.S. in which a study of 1990 data finds ‘there is a quality problem.’ Some officials say that the figures are unfair.

Eight hospitals in California, most of them in the southern part of the state, are among 102 in the nation that have mortality rates significantly higher than might be statistically expected, a government study said Wednesday.

Officials of the U.S. Health Care Financing Administration, which issued the annual report, said most of these institutions nationwide are in inner-city neighborhoods or rural areas. While the report, which covered 1990, did not assess why these hospitals have above average death rates, officials said their compilation of 55 volumes of statistical tables “make it very clear . . . that there is a quality problem.”

The study, which dealt only with institutions that have large numbers of Medicare patients, based its findings on a complex formula. The eight California hospitals listed in the unacceptably high range are:

Martin Luther King Jr./Drew Medical Center, Los Angeles; Robert F. Kennedy Medical Center, Hawthorne; Pacific Hospital of Long Beach; Inter-Community Medical Center, Covina; Redlands Community Hospital, Redlands; Parkview Community Hospital, Riverside; John F. Kennedy Memorial Hospital, Indio, and Valley Medical Center, Fresno. Three of the Hospitals--Pacific, John F. Kennedy and Valley Medical Center--were not on the high-mortality list for 1989, while the rest were.

Correspondingly, the report said, two California hospitals were among 59 institutions with lower than expected mortality rates. They were Green Hospital (Scripps Clinic) in La Jolla and Delano Regional Medical Center in Delano.

The report cautioned that the 1990 figures are intended as guides for health professionals but should not be used as the sole means of determining whether a hospital is good or bad.

“This report is only a screening tool to identify potential problems,” said William Toby, the agency’s acting administrator.

Some hospitals that were named said the statistics were unfair or meaningless because their Medicare patients tend to be more ill than those accepted at other institutions.

Edward J. Renford, administrator of Martin Luther King Jr. in Los Angeles, said in a letter to the agency that its figures were incomplete and inaccurate because they were based on billings “rather than the actual number of patients treated.” Many patients also were in critical condition at the time they were admitted, Renford added.

Gerald S. Goldberg, administrator of Pacific Hospital of Long Beach, said his hospital has a disproportionate number of patients who are likely to die before leaving the hospital, such as terminally ill cancer patients, comatose patients and persons requiring mechanical respirators.

Redlands Community Hospital also said the federal study was based on limited information. Among other factors, 58% of all patients who died at Redlands “had requested the hospital to allow them to die without heroic efforts,” said Gregory L. Hartman, hospital vice president.

“There is nothing wrong with the mortality here,” said Gary Cottongim, president of the hospital. “There is something wrong with” the formula HCFA uses, he said.

Officials at Inter-Community said they had found inconsistencies in the data, which they believe “greatly inflated the mortality rate attributed to us.”

At the Robert F. Kennedy Medical Center in Hawthorne, Patricia E. Cunningham, its president, said the institution “has provided acute health care services for its community for over 65 years.” She attributed its higher mortality rate to the “older and more acutely ill patient populations” at RFK and other similarly situated hospitals.

The health care agency, which is part of the Department of Health and Human Services, said a patient who is considering hospital care “can best use this mortality data in discussing the choice of hospitals with his or her own physician and with hospital personnel.”

The study stressed that “hospitals whose actual mortality rates exceed the predicted rates significantly are more likely to have quality problems than other hospitals.” It added that this annual release of hospital data “is part of a much larger effort by HCFA to measure and improve the quality of care provided to Medicare beneficiaries.”

Times medical writer Robert Steinbrook in Los Angeles contributed to this story.