Tuesday, August 19, 2014

How can patients compare one hospital or system of care to another?

Much has been made of the need for “consumerism” in health care.  Many people believe that a big reason why the U.S. spends so much more than other countries on healthcare without better outcomes than countries that spend far less is because the consumer has been taken out of the equation.  Certain people believe that if the patient only had good information about the quality and cost of their care that the cost would go down. 

Recently, the annual hospital rankings of U.S. News and World Report were released. One should ask himself or herself what the rankings are based on. Do the rankings show that the highest rated hospitals provide the best value for the money spent? Or at least do the highest ranked organizations provide the best health outcomes and the best patient experience even if the price is much higher? If you take the hospitals mentioned in the rankings and examine their actual clinical outcomes and patient satisfaction scores and divide that by the prices that these hospitals charge for those services, you could come up with a value that an educated consumer could use in deciding where to receive their care. 

As has been mentioned before in this blog, The Department of Health and Human Services has created a website where patients can compare the performance of hospitals on many parameters. The website is www.medicare.gov/hospitalcompare.  At this site, a consumer can find comparative hospital data on clinical outcomes such as mortality rates after certain procedures, patient satisfaction scores, and many process measures of care and some outcome data beyond mortality rates for certain disease states.  What you will find, surprisingly is that hospitals that are ranked high, in various high profile national assessments, do not perform any better than hospitals that are ranked lower in the same mass media evaluations. You will also find that many of the highly ranked organizations are among the nation’s most expensive hospitals even if their outcomes are not any better than many less costly institutions. 

What our citizen’s should be desperate for is true and meaningful comparative data so that a patient can rationally choose where they would want to go for elective care.  That is why since early 2013, the GBMC Healthcare System has displayed many of our quality parameters at www.gbmc.org/quality and updated them monthly. Currently, we are the only local community health system doing this and very few others do it nationally. Maryland consumers also know that our rates are set by an independent agency and that agency’s website lists the hospital rates and although the data are somewhat cumbersome to navigate, an educated consumer could use the data to compare value between providers. 

When more of our citizens truly examine outcomes and cost data this will further incentivize healthcare leaders to improve care and drive the waste out of the system and care will be better, faster. Patients will then truly be able to see which hospital or community health system is the best because the rankings were based on the facts.

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 data to reach the correct conclusion.  Have you had an experience in trying to decide who was the best provider for a loved one?

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