Web helps consumers compare hospital care

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Comparing hospitals on various procedures and patient outcomes has been possible for a year now, on the Centers for Medicare & Medicaid Services' Hospital Compare Web site, www.hospitalcompare.hhs.gov. On Thursday the site added numbers on how frequently patients return to a hospital after being discharged, which might raise questions about quality of care.

Three of Pittsburgh's major hospitals, Allegheny General, UPMC Presbyterian Shadyside and Western Pennsylvania Hospital, stand fairly close together in their process of care and outcome of care numbers -- following preferred patient procedures 80 to 100 percent of the time and reaching or surpassing the national rates of preferred outcomes. Some differences do stand out:

Presbyterian fares better than the national average in heart deaths: 7.9 percent compared to a 11.1 percent national rate (data based on Presby's 837 patients over a three-year period). AGH's rate was 10 percent, based on 345 patients; West Penn, 9.5 percent, 276 patients.

Presbyterian also fared better in death rates for pneumonia patients: 7.3 percent, out of 600 patients admitted for pneumonia; AGH (and West Penn) were statistically similar to the national rate, which was 11.5 percent.

In the new data on the site, outcome of care is also measured in readmission rates. A CMMS announcement on the new data said hospital readmissions have been found to reduce the quality of health care while also increasing hospital costs.

Across three years measuring the rate of readmission for pneumonia patients within 30 days of being discharged, Allegheny General's rate was 21.8 percent (based on 230 patients), higher than the national rate, which is 18.2 percent. The other two hospitals were closer to the U.S. rate and, once again, the number of patients was widely different -- West Penn was based on 184 patients; Presbyterian, on 648.

The three city hospitals came close to national rates of patients readmitted to a hospital for heart attack treatment: In the U.S., 19.9 percent of them returned to the hospital within 30 days. For heart failure, 24.5 percent of patients returned to the hospital within 30 days.

The hospitals seem to generally fall together in rates of following similar procedures in patient care, with some exceptions.

For example, a preferred method of hair removal before surgery was used less at AGH. West Penn came in with lower rate of angioplasty for heart attack patients within 90 minutes of arrival at the hospital (national average, 75 percent; AGH, 91 percent; Presbyterian, 85 percent; West Penn, 60 percent). Research continues to compare the benefits of emergency angioplasty and the use of clot-dissolving drugs.

In a survey of patients' experiences, the smaller West Penn fared consistently, if only slightly, higher (from 3 to 6 percentage points) than the other hospitals. For example, 79 percent West Penn respondents agreed to the statement their doctors "always" communicated well and 62 percent said they "always" received help as soon as they wanted. All three hospitals have a majority of respondents who would definitely recommend the hospital: AGH, 64 percent; Presbyterian, 68 percent; and West Penn, 70 percent.

Commenting on the positive results for UPMC Presbyterian Shadyside, Tami Minnier, chief quality officer at UPMC, said they reflect the health system's focus on "evidence-based measures of care that have been shown to improve patient outcomes."

"While there are many other factors to consider when making decisions about care," she said, "having this data available provides consumers another piece of the puzzle."

Jill Daly can be reached at jdaly@post-gazette.com or 412-263-1596.


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