Local hospitals saw more deaths than expected for patients suffering from stroke, amputations due to diabetes, blood infections and hip fracture surgery in 2007-08, according to a new state report.

But the hospitals also had lower-than-expected readmission rates for kidney failure, pneumonia, congestive heart failure and other categories in the 31 common illnesses and procedures included in the Hospital Performance Report, released Wednesday by the state Health Care Cost Containment Council.

A hospital official said some of the higher death rates were due to sick, elderly patients choosing not to have aggressive resuscitation efforts made on their behalf.

With regard to the lower readmission rates at the local hospitals, that is good news for the community, a council spokesman said.

"Readmission rates are gaining increasing attention as both a quality-of-care measure and a cost-containment measure," said Joe Martin, the state cost containment council spokesman. "When you see low readmission rates, it speaks to the fact that patient care is of a very high quality in the first place."

Lancaster General Hospital had higher-than-expected death rates for diabetes with amputation, septicemia or a system-wide infection of the patient's blood and nonhemorrhagic stroke or a stroke caused when a blood clot blocks a blood vessel in or artery leading to the brain.

Lancaster Regional saw a higher-than-expected death rate for the surgical repair of hip fractures.

The higher-than-expected number of deaths came as death rates generally fell in the state. The overall rate for 20 conditions consistently reported by the council declined significantly over the past few years, from 5.1 percent in 2002 to 4.2 percent in 2008, according to the report.

Norma Ferdinand, Lancaster General Health senior vice president and chief quality and nursing officer, said the diabetes deaths were extremely complex patients, and the hospital felt the deaths were not preventable.

With regard to the septicemia deaths, the hospital decided to take a closer look at that illness, which also has a high death rate nationally.

Ferdinand said early recognition and treatment are vital with septicemia, so the hospital worked to standardize its procedures last year. It has seen an improvement in patients, she said.

With regard to stroke deaths, many patients were elderly and had "do not resuscitate" orders, Ferdinand said. Also, the patients often waited too long to obtain treatment, the hospital found.

Ferdinand said the hospital wants to work to get out the message that early treatment is very important for strokes.

Lancaster Regional Medical Center officials were not available to comment on its higher-than-expected death rate in the surgical repair of hip fractures, a spokeswoman said.

LGH had a lower-than-expected death rate for medical management of heart attacks.

Ferdinand said the hospital has a standardized approach to treating heart attacks to stop them from causing extensive damage.

LGH also received good marks for lower-than-expected readmission rates in categories including abnormal heartbeat, acute kidney failure, kidney or urinary tract infections, aspiration pneumonia, infectious pneumonia, stomach and intestinal bleeding and laparoscopic removal of the gallbladder.

Other local hospitals also received good marks for lower-than-expected readmission rates.

Heart of Lancaster Regional Medical Center had lower rates for abnormal heartbeat and infectious pneumonia.

Its sister hospital, Lancaster Regional Medical Center, had lower rates for congestive heart failure and acute kidney failure.

Ephrata Community Hospital had lower rates for congestive heart failure and surgical repair of hip fractures.

The data in the report is from the hospital fiscal year that runs from October 2007 to December 2008.

E-mail: cstauffer@lnpnews.com