Tuesday, August 6, 2013

Which Hospital is the Best?

The last few weeks have seen the release of the annual U.S.News & World Report hospital rankings and the Consumer Reports rankings. The releases triggered discussion in the news media that is long overdue.

How should the consumer decide which hospital is best?

Most would agree that the best hospital is the one that provides the best possible health outcome. Given similar health outcomes, most would also agree that the hospital that provides the best care experience should be judged to be better than hospitals with lower patient satisfaction.

But what about cost?

Most rational thinkers would be willing to pay more if their health outcome would be better and most would probably pay a bit more for friendlier, more comfortable and more timely care. Value = Quality/Cost. Where do patients get the best value for their dollar (or their employer’s dollar, or the taxpayer’s dollar)?

Well, it turns out that the truth is very hard to find. I believe that this has been the classical “chicken vs. egg” conversation. The data needed to decide which hospital is best are not available because historically no one has looked for the data. The news media has recently done stories that are beginning to awaken health consumerism, however. The stories asking why a CAT scan at one hospital costs X and a CAT scan at a hospital a few miles away costs 2X have begun the conversation. Now the uproar regarding the ‘Best Hospitals’ report is continuing.

There are now some unbiased places to go to get good comparative data. The Department of Health and Human Services (www.hospitalcompare.gov) is one such place. Here, a consumer can find good comparative data on patient satisfaction scores, mortality rates, and a number of process measures of care and some outcome data beyond mortality rates for certain disease states. Unfortunately, the data here are generally nine months old because of the complexity of collecting the data from all of the nation’s hospitals.

Earlier this year, we at GBMC began publishing many of our quality measures monthly at www.gbmc.org. However, we are the only local system doing this and very few others do it nationally. When we began publishing this information, we knew that very few patients would look at the data before making a decision of which hospital or health system to use, but we also knew that the organizations that made their data visible to the outside world got better, faster.  So that is why our HealthCare Board authorized us to show the data…good, better, excellent and not-so-good.

It is my sincere hope that the citizens of the U.S. will become more demanding of the evidence of who is truly the best and ignore rankings based on “reputation” without substance. If it were your loved one seeking the answer to the “who is the best” question, you would want him or her to be able to find the true answer.

Update on Dr. Ted Houk

Dr. Ted Houk, the member of the GBMC medical staff who was struck by a car and seriously injured while jogging on March 28th, continues to recuperate and improve with an eye on returning to the practice of medicine in the future. Members of the GBMC family and the community can keep up with his rehabilitation on his Caring Bridge page at http://www.caringbridge.org/visit/tedhouk/journal.

Dr. Houk’s family is also in need of support during this time of recovery. Those who wish to help Dr. Houk and his family should consider donating to his recovery fund. Information can be found at his GiveForward site at https://www.giveforward.com/fundraiser/3pc2/tedhouk.

Thank you for your support and well wishes for Dr. Houk.

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