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New Ratings Track Hospitals' Approach To Chronic Patient Care
Tribune photo by JAY CONNER
Memorial Hospital in Tampa ranks highest in aggressive care - which translates to longer hospital stays and more doctor visits.
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Published: May 29, 2008
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TAMPA – Consumers looking to treat the most serious illnesses have a new way to compare local hospitals.
The rating system released today by Consumer Reports rates nearly 3,000 hospitals nationwide on the length of hospital stays and number of doctor visits for older adults facing chronic diseases including cancer, diabetes, renal failure, dementia, and liver, vascular and heart disease. A total of 31 Tampa Bay area hospitals are included.
The ratings address complicated diseases that affect more than 90 million Americans. As a group, these diagnoses are responsible for seven of 10 deaths of older adults on Medicare, according to the Dartmouth Atlas of Health Care, the key source of data for the rating system.
John Santa, director of the health ratings center at ConsumerReportsHealth.org, said his group simplified the atlas data so consumers can better decide whether they want to fight the disease aggressively – with a slew of doctors and specialists – or as conservatively as possible, such in cases of late-stage cancer or when a person wishes for little treatment. The rating also includes the patient's after-Medicare out-of-pocket expense for the hospital stay.
"If you have a chronic disease, realize that you're getting a different kind of care depending on the hospital you go to. We don't want to make a judgment whether a hospital is good or bad," Santa said. "But when it comes to chronic disease, more treatment does not translate to better care.''
This new rating is just the latest in a slew of health care industry surveys and databases that has emerged over the past several years. Commercial, nonprofit and government sources evaluate centers using a myriad of criteria, ranging from patient satisfaction surveys to accreditation standards to vital statistics.
The Consumer Reports rating, based on Medicare data, shows a variety of aggressive and conservative care at hospitals in Hillsborough, Pasco, Pinellas, Polk and Hernando counties. Memorial Hospital in South Tampa was the most aggressive in doctor visits and stays, earning a 91 percent rating. On average, adult Medicare patients facing chronic illness there spent 24 days in the hospital and had on average 106.2 doctor visits during that stay. Officials from Memorial Hospital's owners, Tennessee-based Iasis Health Care, had no comment.
Pasco Regional Medical Center in Dade City had the area's most conservative care, with a 25 percent rating. Hospital spokesman Susan Frimmel declined comment until officials were able to analyze the data.
BayCare Health System, with nine area hospitals, showed how similar hospitals received varied results in the Consumer Reports findings. BayCare's ratings ranged from South Florida Baptist in Plant City at 47 percent to Tampa's St. Joseph's Hospital at 90 percent.
Denise Remus, BayCare's chief quality officer, said some of the system's busier, larger hospitals such as St. Joseph's may have more specialists on staff, translating to more doctor visits and more aggressive care. The converse may apply to a community-based hospital, where doctors are more familiar with patients, their families and wishes to get more conservative care.
"It does challenge us in a healthy way to ask questions," she said of the Dartmouth Medicare data, which has been compiled annually for nearly 30 years and is respected nationally for its large-scale public health analysis. Internally, BayCare tracks quality issues such as length of stay using data from the Centers for Medicare & Medicaid Services.
Remus said the Dartmouth data is respected but only looks at the sickest of patients facing complex, chronic conditions. The several-week-long hospital stays cited in the Consumer Reports study, for example, are far higher than the five-day average she says is descriptive of all patients at BayCare hospitals.
Web Resources: Choosing A Hospital
There's a plethora of websites offering advice on choosing a hospital. Many others rate medical services using a variety of criteria – from patient surveys to government data. Here's a sampling:
http://www.ahrq.gov/consumer/qnt/qnthosp.htm#choosing – The Agency for Healthcare Research and Quality's recommended checklist for choosing a hospital.
http://www.floridahealthfinder.gov/CompareCare/SelectChoice.aspx The Florida Agency for Health Care Administration's site to view results on health care facility performance, outcome data and information on selected medical conditions and procedures.
www.hospitalcompare.hhs.gov – U.S. Health and Human Services compares how hospitals care for adult patients with certain conditions or procedures. It includes data voluntarily submitted by hospitals, government surveys and Medicare data, and tracks issues such as the rate of death for heart attack and heart failure patients.
http://www.qualitycheck.org/ - The independent not-for-profit Joint Commission's database of health care organizations. The commission, which evaluates and considers accreditation for more than 15,000 groups, is overseen by a board of doctors, nurses and consumers.
http://www.consumerreports.org/health/doctors-and-hospitals - Consumer Reports new hospital rating based on the type of care provided to adult Medicare patients being treated for chronic diseases including cancer, dementia, heart and vascular disease.
http://www.leapfroggroup.org/for_consumers - This consortium of large health care purchasers created its own survey to judge hospital quality and safety.
http://www.dartmouthatlas.org/ - The Dartmouth Atlas Project uses Medicare data to analyze and compare how medicine is practiced across the country. It can search on a national or local basis, and is the impetuous for the Consumer Reports Health.org comparison of aggressive and conservative hospital care.
Reporter Mary Shedden can be reached at (813) 259-7365 or at mshedden@tampatrib.com.
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