Consumers Union, the nonprofit group that publishes Consumer Reports magazine, has just published a ratings review of some 2,463 U.S. hospitals across the nation that specifically measures the quality of the surgical care they offer. The ratings, which are the first of their kind, were based on a survey of the records of Medicaid patients. The survey considered how many of the patients spent more time than average in each hospital, which could indicate either surgical complications or substandard postoperative care. It also considered the percentage of patients who died after surgery.
After examining data for 86 types of surgery taking place between 2009 and 2001, Consumers Union tallied up the results and adjusted them to account for the fact that some hospitals deal with sicker patients than others. It also removed cases in which patients were transferred from one hospital to another. Surgical complications and post-surgery problems like infections were not specifically captured. However, the group believes that those issues were captured adequately for this purpose by the length-of-stay data.
Finally, the group released its results on both overall surgical quality and that of each surgical specialty at the hospital. The results were somewhat surprising, with many high-status hospitals such as Johns Hopkins and the Cleveland Clinic receiving only average overall grades and rural hospitals performing better, on average, than urban ones. You can check the list online on the Consumer Reports website.
While this is a positive step toward giving consumers better information about surgical quality, Consumers Union acknowledges the ratings are based on limited data. Some hospitals would prefer to see the ratings based on specific outcomes in specific surgeries based on a larger survey of patients.
That information is being collected, but it isn’t available to the public. The American College of Surgeons does collect specific data about surgical site infections and other complications, but it is able to do so only by promising hospitals confidentiality. Of the 500 or so hospitals that report surgical outcomes to the ACS, 102 of them voluntarily release some of the data to the Center for Medicare and Medicaid Services.
While the ratings methodology has been criticized, Consumers Union hopes the survey could lead to more transparency with patients.
“One of the reasons we did this was to stimulate debate and irritate people” said Consumer Reports Health’s medical director. “”I think the public would be surprised at all the data they’re not allowed to see.”
Source: Reuters, “For surgery, big and famous hospitals aren’t always the best,” Sharon Begley, July 31, 2013