-- Robert Preidt
TUESDAY, Oct. 19 (HealthDay News) -- Although designed to
highlight high-quality hospitals, the U.S. Medicare Hospital
Compare Web site doesn't help patients select the best facility in
which to have high-risk surgery, a new study contends.
Hospitals submit data quarterly from the Surgical Care
Improvement Project on efforts to prevent blood clots and
infection, in order to receive annual Medicare payment updates.
This reporting -- available to the public at
http:www.hospitalcompare.hhs.gov -- is supposed to help patients
choose superior care and encourage hospitals to improve their
In this new study, researchers analyzed Medicare patients claims
data for 325,052 patients who had one of six high-risk surgical
procedures at 2,189 hospitals in 2005-06. The procedures were:
abdominal aortic aneurysm repair; aortic valve repair; coronary
artery bypass graft; esophageal resection; mitral valve repair; and
The study looked at how often hospitals complied with
recommended measures, and the results ranged from 53.7 percent to
91.4 percent. But compliance scores accounted for only 3.3 percent
of the variance in death rates between the hospitals. The
researchers also found that hospitals that didn't report any data
had similar rates of death to the one-fifth of hospitals with the
highest compliance scores.
There may be several reasons for these findings, the study
"The Surgical Care Improvement Project measures are low-leverage because they relate to secondary and relatively less important outcomes," the researchers at the University of Michigan and Michigan Surgical Collaborative for Outcomes Research and Evaluation wrote in a university news release.
"Even when processes are tied to an important outcome such as pulmonary embolism [a blood clot that has traveled to the lungs], these events are rare and offer insufficient variation to differentiate between high- and low-quality hospitals," they said.
"Despite the intentions of the CMS (Centers for Medicare and Medicaid Services) to provide patients with information that will facilitate patient choice of high-quality hospitals, currently available information on the Hospital Compare Web site will not help patients identify hospitals with better outcomes for high-risk surgery," the study authors concluded.
"The CMS needs to identify higher leverage process measures and devote greater attention to profiling hospitals based on outcomes for improved public reporting and pay-for-performance programs. Future research should ascertain whether process measures become more useful as indicators of surgical quality as public reporting programs mature."
The study appears in the October issue of the journal
Archives of Surgery.
The U.S. Agency for Healthcare Research and Quality has more
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