RAO Davao City

United States Military Retiree Activities Office Davao City, Philippines


Posted by Service Officer on August 29th, 2008

Until recently, hospital death rates were closely guarded secrets, discussed in board rooms but beyond the reach of patients whose lives are on the line. Now anyone with access to a computer can directly compare a local hospital with the one across town to see how it stacks up against the biggest medical institutions nationwide.

Death rates from heart attack, heart failure and pneumonia are widely viewed as yardsticks of a hospital’s overall performance. Last year, the U.S. Centers for Medicare and Medicaid Services (CMS) released a broad comparison of death rates for heart attacks and heart failure, noting how hospitals compared with the national average — better, worse or no different — without releasing the death rates themselves. This year the agency decided to disclose them to consumers. The agency posted its new mortality estimates on a government website www.hospitalcompare.hhs.gov , along with more than two dozen other measures of how well hospitals meet patients’ needs. Among them are statistics on what percentage of a hospital’s patients get appropriate care for a variety of ailments, including childhood asthma, and 10 measures of patient satisfaction with the hospital experience. All three types of measurements give hospitals ways to assess — and improve — their quality of care, but many health officials regard the number of patients who die in the hospital or soon after discharge as the ultimate measure of performance.

Knowing a hospital’s death rates gives consumers more power to influence the quality of their medical care, says Lisa Iezzoni, associate director of the Massachusetts General Hospital Institute for Health Policy. “What the mortality rate does is give you an entree to talk to your doctor and say, ‘Look, is this hospital stay going to kill me?’ ” That’s not an easy question to answer with any certainty. By trying, officials knew they were courting trouble with the hospital industry, Iezzoni says. An earlier effort by Medicare to report on hospital death rates faltered in the early ’90s. The agency wilted under relentless criticism that its so-called death list didn’t give adequate weight to a hospital’s mix of patients, including how sick, poor and old they were. This time, the architects of the new analysis took a different approach. They tallied death rates for common life-threatening conditions, not the hospitals’ overall mortality rates. And they chose a strict statistical formula that allows them to say with 95% confidence that a hospital’s death rates fall within a certain range. But there’s a rub, experts say. Using this method of analysis, only a handful of hospitals stand out as better or worse than the national average. The new formula captures all deaths among 35 million Medicare beneficiaries that occurred within 30 days of the patients’ hospital admission. They also factored in the hospital’s patient mix and how many deaths might be expected in a hospital with that population. Including deaths that occurred within 30 days after admission made it tougher for a hospital to game the system by shipping risky cases somewhere else.

• To compare hospitals near you on heart attack, heart failure and pneumonia refer to www.usatoday.com/news/health/hospitals-graphic.htm

• To view hospitals with highest and lowest death rates www.usatoday.com/news/health/2008-08-20-hospitals-best-worst_N.htm

• To compare hospitals in your ZIP code refer to www.hospitalcompare.hhs.gov/hospital/mortalitytool/index.asp

[Source: USA TODAY Steve Sternberg/ Anthony DeBarros article 20 Aug 08 ++]

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