A report measuring the quality of hospitals shows that Hawai'i's medical facilities are improving, though at a rate that's slower than the national average.

Hawai'i's hospitals have managed to lower their mortality rate almost 4 percent from 2004 to 2006, according to the 10th Annual HealthGrades Hospital Quality in America Study being released today.

That's compared with the average 11.7 percent decline in the mortality rate of the 4,599 hospitals it studied in the United States.

The report is one of several that measure and try to rank hospital and doctor performance as the medical profession strives to increase the quality of care they are providing. Besides HealthGrades, which is a private company, the U.S. Department of Health and Human Services operates the Hospital Compare Web site, while Evanston, Ill.-based Solucient issues a study looking at both clinical and financial performance.

The HealthGrades report looked at data from 41 million Medicare discharges at U.S. hospitals from 2004 through 2006. Risk-adjusted death and complication rates were calculated for 28 diagnoses and procedures. These ranged from hip replacements to pneumonia and heart failure. It included 17 Hawai'i hospitals in the study.

The overall results show that 13 local hospitals, or 76 percent, fell into the middle ground of performance. None of the hospitals were ranked within the top 15 percent of facilities nationally, while four local hospitals were among the bottom 15 percent nationally.

Local medical officials have noted previously that such rankings may do an injustice to Hawai'i hospitals because of factors that are specific to the state. This includes Hawai'i's long-term-care shortage, among the worst in the country. That means hospital patients may remain longer in medical centers while waiting for a nursing home vacancy to open up.

More patients tend to die in local hospitals than other places because there is also a shortage of hospice care facilities. That translates into a higher mortality rate for the Hawai'i units.

Medical officials also have said the low rankings may be affected by attitudes of certain ethnic groups toward dying outside of hospitals and different health care problems those groups experience compared with the Mainland.

Recently, Castle Medical Center assessed its own report on boosting the quality of its services to help it monitor its progress.

In August, a dozen Hawai'i hospitals committed to the 5 million Lives Campaign, a national program aimed at making hospitals safer by lowering medical errors over a two-year period.

Reach Greg Wiles at gwiles@honoluluadvertiser.com.