By Ron Reed / Guest Column
Determining a country’s health status or determining which hospital and doctors to see has been demystified by comparisons conducted between countries and hospitals.
According to the World Health Organization (WHO), health is the state of well-being and not just the absence of disease and disability. We make comparisons between countries as shown in The Commonwealth Fund’s publication, U.S. Health Care from a Global Perspective, which measures the number and percentage of the public who have coverage, the percent of gross domestic product (GDP) spent on health care and the amount of mortality and morbidity; that is, the incidence and prevalence of disease.
These data are important to society because they compare the performance of each country and allow policymakers to identify where a society needs to improve. For example, according to The Commonwealth Fund, the United States is the most expensive country for health care (17.1 percent of GDP), does not have universal coverage and ranks lower on quality scores than other developed countries.
But what most people want to know is: to what doctor or hospital should I go for treatment of my medical problem, such as high blood pressure, diabetes, heart disease, orthopedic and general surgery?
Fortunately, several companies have emerged to independently provide this type of information before consumers select a doctor or hospital.
One company, Truven Health Analytics, has become the leader in providing comparative information on hospitals. They collect data from public sources such as Medicare Provider Analysis and Review (MEDPAR), the Centers for Medicare and Medicaid (CMS) and the Medicare cost report. Hospitals are then classified into five comparison groups according to size and teaching staff: major teaching, teaching, large community, medium community and small hospitals.
Each hospital is scored objectively on the 11 indicators including the following: mortality or death rate, complications, a series of quality indicators regarding common health problems, mortality rates for heart attacks, heart failure, chronic obstructive pulmonary disease (e.g. emphysema), pneumonia and stroke.
Moreover, they measure the readmission rates within 30 days for common medical problems, length of stay in a hospital, timeliness of emergency room patients admitted to a patient floor, three financial indicators and patient satisfaction scores as measured by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).
The hospitals in each of the comparison groups are then ranked based on their performance on each indicator. From this ranking, they determine the top 100 hospitals in the U.S., or the top 20 hospitals in each of the five categories. These rankings are then available on Truven Health Analytics website, www.100tophospitals.com.
In summary, Top 100 Hospitals have better survival rates, fewer patient complications, follow accepted care protocols, have lower 30-day mortality and readmission rates, send patients home sooner, provide more timely emergency care, keep expenses low per patient, are more profitable and have higher patient satisfaction ratings.
Another company, Healthgrades, provides comparative information about physicians, hospitals and other health care providers. Doctors are evaluated on experience with certain health procedures or health conditions and patient satisfaction, but it is important to look at the rating of the hospital where the doctor has privileges as well.
Hospitals are rated on risk-adjusted mortality for specific procedures or diagnoses and on complication rates; these data come from Medicare. The hospitals are given one, three or five stars based on whether the hospital has results worse than expected, at predicted levels or better than expected. A five-star rating for a particular procedure shows superlative results.
Using tools and information from The Commonwealth Fund (www.commonwealthfund.org) to compare health status of countries provides legislators and policymakers with useful information on how a country can improve the health of their population.
Information from Truven Health Analytics (www.truvenhealth.com) allows you to do a comparison between hospitals, and Healthgrades (www.healthgrades.com) gives consumers information about doctors and hospitals for certain medical conditions and procedures.
Ron Reed is president and CEO of Mercy Iowa City.
