Hospitals need to be on the hook for "higher leverage" safety measures if the Department of Health and Human Services' wants its Hospital Compare website to ever be taken seriously. At present, the site--created to help patients pick the best facility for them based on various hospital statistics--is proving unhelpful for Medicare patients who need risky surgeries, according to a report published this week in the Archives of Surgery.
In looking over more than 325,000 "high-risk surgery" patient cases at 2,000 hospitals between 2005 and 2006, researchers found the information inconclusive. Good ratings on process measures, or how a procedure was performed, did not necessarily translate into better patient outcomes. For example, hospitals that boasted a 90 percent compliance rate for quality measures didn't necessarily have a low post-operative death rate to match.
"[M]ortality rates in the lowest compliance hospitals were statistically indistinguishable from those in the highest quintile of compliance for all procedures studied except aortic valve replacement," write the report's authors, led by Lauren H. Nicholas, PhD, of the University of Michigan and Michigan Surgical Collaborative for Outcomes Research and Evaluation.
While hospitals with higher compliance were able to say they could reduce a patient's risk of having an "extended stay," according to NPR's health blog Shots, clearly more is needed.
"Despite the intentions of the CMS to provide patients with information that will facilitate patient choice of high-quality hospitals, currently available information on the Hospital Compare website will not help patients identify hospitals with better outcomes for high-risk surgery," Nicholas and her colleagues conclude. "The CMS needs to identify higher leverage process measures and devote greater attention to profiling hospitals based on outcomes for improved public reporting and pay-for-performance programs."
To learn more:
- here's the report's abstract in the Archives of Surgery
- read this NPR Shots blog post
- check out this Infection Control Today piece