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Healthcare Ratings: How They Stack Up.
Over the years, most people have relied on recommendations from friends and family when choosing a doctor or hospitals. With the rise of the Internet, easily and often accessed by health consumers, ratings and rankings boomed. To be an informed consumer, it’s good to understand what information each rating uses and how it is compiled. Here’s a brief overview.
Organizations compile their ratings with different information, from different sources with different formulas to make the data consumer-friendly. Here are the most common ways in which ratings are generated:
Patient Surveys. Former patients are asked to fill out a questionnaire about their experience.
Reputation. How would others in health care rate your hospital?
Self-Response Questionnaire. Hospitals are asked to fill out a questionnaire about their practices and results.
Medicare Data. Most health care records are private. Because the federal government pays for Medicare coverage, this information (without specific patient identification) is available to the public. Although, the data by itself may overwhelm a consumer, companies employing statisticians, mathematicians and computer experts to process the information for consumer consumption.
For the most part, hospital “quality” ratings are built on several criteria. Here are some of the most common measurements:
Patient Satisfaction. Were you pleased with your care? Did the doctor answer your questions? Was it quiet in the hospital? Did nurses respond to your requests for assistance? Was it clean?
Medical/Clinical Outcomes.In general, these measures try to answer determine if the treatments were appropriate and effective. Three general types of information are reviewed:
Safety.Do patients receive the correct medication? How often do patients trip and fall?
Length of Stay. How long were patients with a specific health condition in the hospital? Organizations using this measurement generally believe that shorter length of stay (LOS) equates with quality care, although some critics suggest that simply equating length of stay with surgical safety is oversimplifying the case.
Complications/Re-admissions. If a patient has a surgical complication or gets an infection or pneumonia while in the hospital can be used as a measure of quality. If patient is released, then readmitted a short time late for problems related to the original hospitalization, quality ratings can also be affected.
To help you better decide which hospital ratings are most meaningful for you and your family, here are some of the most common:
Comparing the Comparers
To better understand what these rating organizations are telling you and how they are reaching that decision, here’s an overview of some of the most commonly mentioned ones.
Healthgrades is a private company that offers its ratings to the public on its web site Healthgrades.com. Healthgrades evaluates hospitals solely on clinical outcomes and incorporates information on patients who die in the hospitals and in-hospital complications. For data, it uses 40 million Medicare hospital discharges from the most recent 3-year period. It examines 31 common procedures and conditions, adjusting its data for each patient’s age, gender and medical condition.
Hospital Compare is a service of the federal Centers for Medicare & Medicaid Services (CMS) that uses 1) data from the 4,500 hospitals participating in Medicare (health insurance for older adults) and Medicaid (health coverage for low-income families and disabled individuals) and 2) a national survey of patient experience.
Hospital Consumer Assessment of Healthcare Providers & Systems (HCAHPS), like Hospital Compare, is a government program.Hospitals are required to collect and submit survey information from patients. Independent survey companies also survey a selected population.
Leapfrog is an employer-based coalition that seeks to measure safety by having hospitals fill out and submit a questionnaire. Not every hospital chooses to fill out the questionnaire.
US News & World Report magazine rankings historically have been “reputational.” One study found that the largest health systems tended to rate better. One study found that high-cost hospitals also tended to do better in this ranking.
Consumer Reports’ system is a hybrid, gathering public information, surveys, and state data. In an attempt to simplify, Consumers Reports uses its familiar ratings symbols. It has been criticized for 1) using length of stay for a surgical safety measure, something no other ratings organization does and 2) failing to make public is its methodology for calculating the final rating.
So, What Can I Do?
About a third of all US hospitals annually receive an honor from one of the rating organizations. So, the best advice for consumers would be to:
Look for hospitals that receive positive rankings from more than one of the groups or
Look for a healthcare system that receives multiple awards from one of ratings organizations.
What about McLeod?
“McLeod Health has been honored nationally for its quality programs by a variety of national organizations,” says VP for Quality Donna Isgett. “We were the first health system in South Carolina to receive the American Hospital Association/McKesson Quest for Quality Award.
“This year, we were humbled that Healthgrades selected McLeod Regional Medical Center for more quality honors than all but one other hospital in SC.”
To learn more about our quality, click here.
Sources include: McLeod Health, Healthgrades, Leapfrog Group, Consumer Reports, US Department of Health & Human Services