Consumers now have access to some information for comparing hospitals (there are legislative mandates behind this trend, and also market-driven forces). In California, info is available at a site called CalHospitalCompare.org. So how does it work? The site does a respectable job of clearly presenting options and search results.
Here's a comparison of hospitals in zip code 94089. Ouch, in this particular case, the results reflect unfavorably on Kaiser. But can a simple red or green light weigh in all the evidence about factors that could affect the quality of hospital care?
The site offers this overview of the rating system: "Hospitals on this site are rated on quality and timeliness of care for several conditions, as well as patient satisfaction with overall, medical, surgical, and maternity care, and adherence to recommended patient safety practices. With the exception of patient safety, hospitals are rated on a five point scale, based on their performance:
Superior: Hospital performed well above average compared to other hospitals on this measure.
Above average: Hospital performed better than average compared to other hospitals on this measure.
[etc. etc....] Poor: Hospital performed well below average compared to other hospitals on this measure."
Next I wondered how the data was collected. What if one hospital is an HMO, and the other isn't -- wouldn't that affect the types of patients they see, how they gather data, and how people respond? The site does address variations in patient mix. But I'm guessing this might not be what Joe Sixpack is looking for when he shops for healthcare:
"There are many factors that have an impact on how well a patient with a given condition or procedure will do, and these factors have an effect on how the performance ratings for those conditions are calculated as well. For instance, having diabetes can reduce your chances of surviving heart surgery, so a hospital with more diabetic patients than average should have its death rate adjusted. However, having diabetes does not prevent the nurse from checking your wristband before giving a medication, so there should be no adjustment for diabetes in that measure. [etc. etc. etc....] Therefore, for each condition, the most modern, state-of-the-art adjustment procedures available were used to account for variations in patient mix. The following organizations provided the rules for collecting the data and adjusting for patient differences when necessary:
- Heart Attack, Heart Failure, and Pneumonia Care: the Joint Commission on Accreditation of Healthcare Organizations and the federal Medicare program;
- [etc. etc....] Patient Experience Surveys: the National CAHPS Benchmarking Database (the national center for collecting patient surveys) and the NRC+Picker Group; and Patient Safety: the Leapfrog Group."
It's great that we're getting more transparency into the performance of medical facilities. But consumer-driven healthcare has a long way to go.
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