The reset: Patients are sicker, but outcomes are improving

Patients are sicker, but outcomes are improving

One of the more counterintuitive findings in Vizient's 2026 State of the Industry Report is that patient outcomes have improved even as the population arriving at hospitals has grown older and sicker. Medical Economics asked Shannon Sims, M.D., Ph.D., FAMIA, chief product officer at Vizient, and Matthew Bates, M.P.H., managing director at Kaufman Hall, what's actually behind that.

Sims pointed to Vizient's clinical database, which aggregates inpatient discharge data from roughly 1,500 hospitals every month. Across that data set, the numbers show a genuine decline in quality and safety events — patient falls, surgical infections and similar measures.

He was careful not to attribute it to any single intervention. Two things are happening together, he said: Health systems are paying more serious attention to quality as a strategic priority, with many using Vizient's data as a direct input into board-level reporting, and policy incentives and penalties are reinforcing the right behaviors.

"A combination of increased mission focus plus a mix of carrots and sticks has really moved the needle," Sims said.

Bates added a demographic layer that shapes how to read those numbers. The patients who can be safely managed in lower-acuity settings increasingly are in ambulatory surgery centers, at home or using virtual care.

That means the patients who remain hospitalized are, on average, more complex than they used to be. The case-mix index, a standard measure of inpatient complexity, reflects that. "The ones left in the hospital are definitely getting sicker," Bates said.