Lifting the veil on hospital care

Federal and private Web sites offer quality and cost data

The Dallas Morning NewsJuly 12, 2009 

  • In the Triangle, for surgery to relace a hip, knee or ankle, the amount charged to Medicare varies, according to Hospital Compare, a federal Web site.

    Hospital

    Avg. cost

    WakeMed Raleigh campus

    $13,499

    Duke Health Raleigh North

    $10,897

    Rex Healthcare

    $10,719

    The Web site also offers survey results on patient satisfaction and compliance with a list of straightforward medical safety procedures. All three scored well on such things as giving patients the right antibiotic at the right time. Scores for all three were lower when it came to communication from doctors and nurses.

    For details, www.hospitalcompare.hhs.gov

— Light is starting to peek into the dark confusion of health-care quality and costs.

For consumers who want to know, there are now ways to compare cost estimates for surgeries. You can learn how often hospitals lose patients as customers, and how often they get them back after less than a month, because of complications and mistakes.

This increased transparency is one of the great hopes among health-care reformers for tackling the high cost of American medicine. Employers, who pay for most health care through employee insurance, are pressing for more information and are giving it to their workers.

You can go online and do some comparison shopping for a hospital at the federal Web site www.hospitalcompare.hhs.gov.

The Leapfrog Group, the health-care watchdog of the nation's largest employers, runs a Web site -- www.leapfroggroup .org -- for consumers to review and compare local hospital safety, quality and efficiency information.

Consumers Union offers a site that reports hospitals having the most trouble stopping the spread of infections among patients ( www.stophospitalinfections.org/infection--prevention/).

Much of this material comes from the U.S. Department of Health and Human Services. The department's Centers for Medicare and Medicaid Services collects mountains of information from hospitals and doctors who treat Medicare and Medicaid patients.

Until recently, however, the department hasn't been able to do much data mining with this information.

The department's Hospital Compare site starts things moving in the right direction. With a few keystrokes, you can line up any three hospitals to judge where you'd like, say, a hip replacement.

The Leap Frog Group takes this data several steps beyond straightforward comparisons. They fault the medical community for doing a poor job of protecting patients from medical errors, and they found scant compliance with proven treatment courses that cost less.

The group's latest hospital survey of more than 1,276 hospitals was released in April.

"As the Obama administration and Congress consider health care reform options, it is clear we have a long way to go to achieve hospital quality and cost-effectiveness worthy of the nation's $2.3 trillion annual investment," said Leapfrog CEO Leah Binder. "According to our data, a majority of hospitals have significant safety and efficiency deficits."

Whether patients will respond to the data now available by choosing higher quality, lower cost hospitals, though, is not clear.

"I don't think consumers are ready to make a choice on a hospital," said Marianne Frazen, executive director of the Dallas-Fort Worth Business Group on Health, which represents area businesses that provide health insurance for employees. "Most people still go where their physician tells them to go."

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