Federal Website Spotlights Poor-Performing Hospitals

A federal website recently began publishing patient safety ratings for thousands of hospitals, aiming to put pressure on institutions with high rates of surgical complications and medical errors.

The website, Hospital Compare, takes into account how often patients suffer complications such as a collapsed lung, a blood clot, or an accidental cut or tear during treatment. In addition, the website ratings reflect death rates for patients who have, for example, a treatable complication after an operation.

As Kaiser Health News reports, the website also rates hospitals on how frequently patients develop inflections or suffer falls, and it tracks such medical errors as giving patients the wrong type of blood or leaving surgical instruments in patients’ bodies.

Hospital Compare is part of an effort by the Medicare program, under last year’s health care reform legislation, to prod poor-performing hospitals to improve.  There also will be financial pressures — hospitals judged by patient safety and other measures to be among the lowest quality could lose up to 2 percent of their regular Medicare reimbursements.

In many cases, data on the website remain sparse. The “serious complications and deaths” area, for example, often indicates that too little information is available to reliably indicate a hospital’s performance. And the rankings, rather than providing a precise measure, may simply say that a hospital’s death rate is “no different than” the national rate.

Still, many patient safety advocates welcome the public release of more information about hospitals. “This is pulling the curtain back on preventable health care harm to older Americans,” said Rosemary Gibson, co-author of “The Treatment Trap” and editor of a series of articles on overtreatment in the Archives of Internal Medicine. “These are really good things to know. We are really getting into the meat of what can happen to patients in hospitals.”

The ratings have drawn objections from the hospital industry and some academic researchers who contend that Medicare is using dubious measurements that often are unfair, particularly to institutions with sicker patients. The evaluations are based on billing claims, not clinical medical records.

“We believe the data is fairly seriously flawed in the way it’s calculated,” said Nancy Foster, a vice president at the American Hospital Association. “When inaccurate data is out there, it both misleads the public and generates a lot of activity that is unproductive in the hospital.”

As The New York Times reported last month, in a separate attempt to promote health care accountability, the Joint Commission released a list of top-performing hospitals. The commission is the country’s leading hospital accreditation board.

STUART SILVERSTEIN

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