By Ulfat Shaikh
If you pick up the August 2012 issue of Consumer Reports, you might get to check out just how safe your local hospital is. The magazine has published safety scores for 1,159 hospitals in 44 states, based on rates of infections, readmissions, communication with patients, CT scanning, complications, and mortality.
Hospitals were scored on a 100-point scale. More than half of hospitals received an overall safety score below 50 percent. All hospitals had quite a way to go to make their care stellar. The highest performing hospital, Billings Clinic in Montana, received 72 points. The lowest performing hospital, Sacred Heart in Chicago, received 16 points. Most hospitals fared badly due to two systemic issues — those related to readmissions and communication.
There are some obvious issues with rating hospitals. One source of information before the Consumer Reports rating was The Leapfrog Group’s controversial scoring system. This system grades hospital safety using letter grades from A through F, much like a report card. Comparing Leapfrog and Consumer Reports scores can result in significantly different ratings. For example, Massachusetts General Hospital received an A from Leapfrog, but earned a score of 45 from Consumer Reports. Consumer Reports advises its readers that to get a complete picture, they examine their ratings along with ratings published elsewhere, such as from Hospital Compare and Leapfrog.
Consumers also need to take ratings, grades, and scores at face value, keeping in mind the context these hospitals operate within. For example, many highly regarded hospitals scored low in the area of safety: Mass General (score 45), Ronald Reagan UCLA (score 43), Cleveland Clinic (score 39), Mount Sinai (score 30). These hospitals look after a large number of patients with limited ability to receive follow-up care — the poor, the uninsured, those suffering from substance abuse or mental illness — increasing their hospitals’ readmission rates. Some of these hospitals tend to take care of more non-English speaking patients, which might affect their scores on communication. Consumer Reports’ ratings currently include only 18 percent of hospitals in the United States, since such data aren’t publicly reported fully or consistently by all hospitals.
In the end, transparency is what it’s all about. If I cross-check Yelp and the Davis Wiki before eating out at a restaurant, I suppose it is not such a bad thing to have more than one source available when checking out my medical care.
–Ulfat Shaikh, MD, MPH, MS is director of health care quality integration at the University of California Davis Schools of Health. She blogs about health care quality improvement at Pulse.