Consider source when reporting hospital rankings
HealthGrades, a health care ratings company, has released a report (PDF) that says “Medicare patients treated at top-rated hospitals nationwide across the most common Medicare diagnoses and procedures are 27 percent less likely to die, on average, than those admitted to all other hospitals.”
The report also names the hospitals that HealthGrades has deemed “Distinguished Hospitals for Clinical Excellence.”
That study (PDF) and the designations for hospitals are prompting a number of news articles reporting that local hospitals have been named as “top hospitals.”
But there are some things to think about when examining hospital rankings. For one thing, hospitals pay HealthGrades to use its information as promotional material. In addition, the data HealthGrades uses can be out of date and is based only on Medicare patients. A 2002 review found that “ratings on individual hospitals were often misleading.”
Charles Ornstein of ProPublica wrote a thorough tip sheet about how to cover your local hospital, including information about HealthGrades and other hospital rankings.
For a more balanced comparison of local hospitals, consider using the Hospital Compare patient survey data from the Department of Health and Human Services. AHCJ has made it easier for journalists to compare hospitals in their regions by generating spreadsheet files from the HHS database, allowing members to compare more than a few hospitals at a time, using spreadsheet or database software.
AHCJ provides key documentation and explanatory material to help you understand the data possibilities and limits. Need help analyzing Excel files? AHCJ offers a tutorial about investigating health data using spreadsheets.
Study: Hospital quality rankings inconsistent
A study published in the November/December 2008 issue of Health Affairs finds that five consumer-oriented Web sites that rank hospital quality are inconsistent and likely to confuse consumers.
The study involved rankings provided by Hospital Compare, HealthGrades, Leapfrog Group, U.S News and World Report, and Massachusetts Healthcare Quality and Cost (a state-run service). Researchers compared community-acquired pneumonia, total hip replacement, percutaneous coronary intervention, and coronary artery bypass grafting at nine Boston-area hospitals.
In American Medical News, lead author Michael B. Rothberg, M.D., M.P.H., said, “I don’t think these ratings are at the point where doctors or patients can really use them.”
Rothberg, an assistant professor of medicine at Tufts University School of Medicine in Boston, also said that “Public reporting was created to be a tool for consumer choice and to improve quality, but the inconsistency in these systems does a disservice to patients rather than achieve its true potential.”
The American Medical News article also includes reactions from representatives of the rankings.
Note: Remember, AHCJ members can sign up for free access to Health Affairs.
Coverage of nursing home rankings varies
Last week the the Centers for Medicare & Medicaid Services released new ratings for nursing homes - both for-profit and nonprofit - that uses a five-star system to measure quality, staffing and health inspections, plus an overall score. Not surprisingly, coverage of Nursing Home Compare in many newspapers focused on the ratings assigned homes in their readership areas.
This makes sense, of course, because readers are less likely to be interested in CMS ratings for out-of-town nursing homes. And in an era where newspapers are increasingly orienting their pages toward ‘hyperlocal,’ the new CMS rating system - which is akin to the ranking in a Zagat restaurant guide - serves up a local angle on what is actually a national issue.
Some coverage, however, dug a little deeper. USA Today, for instance, conducted its own analysis contrasting the performance between for-profit and nonprofit nursing homes. And, while the Houston Chronicle played up the local angle, the paper also examined the data more closely, as it pertained to homes in its region, and highlighted reservations about the CMS ranking system. And a U.S. News & World Report blog pointed out some shortcomings.
There was a long list of stories about the system, and we’re wondering what you think about some of the approaches taken. Should the local angle trump other discussion? How important is it for a local newspaper, no matter how big, to poke around the data for more tidbits? Drop us a line.
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