Rural, Urban Hospitals Score Highly in Consumer Reports Surgery Ratings; Teaching Hospitals Fall Short

Location, location, location.

While it definitely impacts the price of real estate, it doesn’t necessarily impact a hospital’s surgery rating, according to Consumer Reports’ first ratings survey on how patients fare during and after surgery.

In fact, some hospitals do a much better job than others, despite their location. The report reflects wide variation, sometimes between hospitals only a few miles apart. For example, the Greater Baltimore Medical Center earned high marks on the overall surgery rating, as well as for several individual procedures, but the Johns Hopkins Bayview Medical Center, also in Baltimore, got a low overall surgery rating.

And urban and rural hospitals can and do excel, despite being located in areas that serve poorer, sicker patients, according to the report. Mount Sinai Hospital in New York and University Hospitals Case Medical Center in Cleveland scored highly, as did several rural hospitals.

The ratings are important because up to 30 percent of hospital patients suffer infections, heart attacks, strokes, or other complications after surgery, but these records are largely hidden from consumers, Consumer Reports says.

Although hospitals are required to report to government agencies and some submit data to national registries to see how they stack up against one another, vital safety information remains out of consumers’reach, the report states.

Consumer Reports’ ratings include an overall surgery rating, which combines results for 27 categories of scheduled surgeries, as well as individual ratings for five specific procedure types: back surgery, hip replacement, knee replacement, angioplasty and carotid artery surgery. They are based on an analysis of billing claims submitted by hospitals to Medicare for patients 65 and older, from 2009 through 2011, and cover 2,463 hospitals in all 50 states, Washington, D.C. and Puerto Rico.

The surgery ratings are based on the percentage of a hospital’s Medicare patients who died in the hospital or stayed longer than expected for their procedure. Research shows that mortality and length of stay correlate with complications, and some hospitals themselves use this approach to monitor quality.

Key findings from the report includes the following:

  • Teaching hospitals often fell short. Teaching hospitals, thought to represent the nation’s best and the recipients of generous federal funding, on average performed no better than other hospitals surveyed.
  • Big name hospitals don’t always live up to their reputation. For example, though several Mayo Clinic hospitals did well, others rated only average. And the Mayo Clinic Health System in Austin, Minn., got a low overall rating.
  • Specialty hospitals tend to do better. Six of the top performers for carotid artery surgery were heart hospitals. But that’s not always the case. Despite earning high marks in other Consumer Reports’ ratings that focus on infections related to surgical incisions, Hospital for Special Surgery in New York, which specializes in orthopedics, got low marks in new hip and knee surgery ratings, which look at how surgery patients fare over their entire hospital stay.
  • Hospital choice matters more for some procedures than for others. For example, Consumer Reports found wider variation for several surgeries, including hip and knee replacements and back surgery, than for others, such as colon surgery and hysterectomy.

To develop the ratings, Consumer Reports worked with MPA, a healthcare consulting firm with expertise in analyzing billing claims and clinical records data and in helping hospitals use the information to improve patient safety. The complete report is available in the September issue of Consumer Reports.

Source: Consumer Reports, July 31, 2013

2012 Healthcare Benchmarks: Reducing Hospital Readmissions provides critical benchmarks that show how the industry is working to reduce rehospitalizations, particularly for the CMS target conditions of heart failure, myocardial infarction and pneumonia.

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