The Division of Health Care Finance and Policy, using data posted on the Quality and Cost Council’s website (www.mass.gov/myhealthcareoptions), issued a report allowing for a side-by-side comparison of hospitals’ quality ratings and costs for care for a defined set of treatments and conditions.
The report also includes summary pages for each hospital, with an overview of their quality and cost data. The quality data includes both outcome and process measures and both quality and cost data are adjusted for severity of patients’ illnesses to allow for comparison among hospitals.
The report exposes wide variation across hospitals for some measures, and others for which there is little variation. For example, the mortality rate for stroke ranges from a high of 18.5 deaths for 100 discharges to a low of zero deaths (the data is risk adjusted, so the comparisons are valid). There are also wide variations in costs, especially when looking at those related to imaging, with, for example, the cost for a chest CT scan ranging from $350 to $1300.
The hope is that this data can help policymakers, providers and others to understand variations in quality and cost and take steps to reduce the variations so that all hospitals provide high-quality care and those providing the same, or worse, quality of care at higher costs can reduce their costs. The data also helps consumers as they make health care choices-both in terms of quality and cost.
One of the pages comparing quality data across hospitals looks at the percentage of patients who rated the patient experience at a given hospital as “high.” This ranges from a low of 52% to a high of 84%. One wonders what the highest-rated hospitals are doing well, leading to high rates of satisfaction, and what the lowest-rated hospitals are not doing well. The hospitals should work with their Patient and Family Advisory Councils (all hospitals are required to establish them by October 2010) to figure out how they can improve patient experience as well as other quality of care measures. Without including the voices of patients and family members, along with those of medical staff, many of the numbers in this report are unlikely to change.
-Deborah W. Wachenheim
