Do you know how safe your hospital is? Death and complications rates vary widely among hospitals, even in the same city.
“Go to the Wrong Hospital and You’re 3 Times More Likely to Die”
“…researchers found that patients at the worst American hospitals were
three times more likely to die and 13 times more likely to have medical complications
than if they visited one of the best hospitals.”
NY Times Dec. 14, 2016
Hospitals are the Key to determining Healthcare Quality
Since publishing Finding the Best Healthcare You Can Afford last spring, we have focused on hospitals because.
- Choosing a hospital makes finding a doctor much easier, especially if you live in a metropolitan area where there may be literally thousands of doctors from which to choose.
- Hospital quality is measurable, whereas individual doctors can be judged only by indirect measures, such as board certification, group practice and hospital affiliation.
- There are numerous organizations that rate hospital safety and quality, including Leapfrog, US News, Consumer Reports and various health plans that tend to favor their network providers. which may be chosen based on cost or other factors rather than safety.
- While most of hospital rating organizations include CMS outcomes (deaths and complications), they combine them with many other inputs that dilute the results and make it difficult to identify low death rate hospitals.
We think it is important for the consumer to have direct access to hospital outcomes, as measures by deaths and complications. As a result, we have take a deep dive into the data and developed a national rating system by comparing rates of death and complications for almost 4,000 hospitals. We are developing a more comprehensive database that includes safety ratings from various sources, such as Medicare and the Leapfrog Group.
Why Hospital Outcomes Scores?
While researching Finding the Best Healthcare You Can Afford, we found it difficult, even with the best of hospital rating services, for the consumer to find and use CMS (Centers for Medicare & Medicaid Services) hospital outcomes (deaths and complications) as a basis for choosing a safe hospital. As a result, Amory Associates has created a new hospital rating system – Hospital Outcomes Scores (HOS) – based on death and complication rates compiled by CMS.
Hospital Outcomes Scores consist of Hospital Death Scores and Hospital Complications Scores, both derived from the same CMS outcomes data used by every major hospital rating service. Each outcome is scaled from 0% (lowest rate) to 100% (highest rate) in a way that yields a median at 50%. All 7 death outcomes for more than 4,000 hospitals are then averaged together, and the averages rescaled from 0% (lowest rate) to 100% (highest rate) in a way as above that yields a median at 50%. Complications Scores are determined similarly.
HOS vs other Hospital Ratings
Unlike other rating systems, Hospital Outcomes Scores focus entirely on outcomes:
We compared Hospital Safety Grades and HOS Death Scores for the hospitals with the 20 lowest Death Scores in the country and found substantial variations in their Hospital Safety Grades.
We also compared Hospital Outcomes scores and Hospital Safety Grades for a sample of 200 hospitals from six states, which were selected based solely on geographic considerations, i.e. no bias. The chart below shows variations in outcomes within a Hospital Safety Grade that far exceed the variations from one Grade to another.
A review of Medicare hospital ratings shows similar results:
These findings are corroborated by research at the University of Michigan, which concluded Hospital Safety Grades don’t reflect comparative death and complication rates (outcomes).
“ there was negligible difference in mortality or complication rates among hospitals receiving A, B, or C grades. There were no statistically significant differences across grades for readmission rates” (emphasis added) from “Hospital Safety Scores: Do Grades Really Matter?”
by Andrew A. Gonzalez, MD, JD, MPH and Amir A. Ghaferi, MD )
State Hospital Outcomes Scores
For more about HOS go to Hospital Outcomes Scoring System. To be notified when details about the safest hospitals in your area become available, add your name to our mailing list.
Individual Hospital Outcomes Scores
We are currently beta testing online Hospital Outcomes Scores for the following areas:
- San Francisco Bay Area 45 hospitals
- Southeast Florida 42 hospitals
- Massachusetts 44 hospitals
- New York Metro & LI 59 hospitals
- Maricopa County, AZ 26 hospitals
- Philadelphia, PA 10 hospitals
We have included, where available, Hospital Safety Grades, Medicare Hospital Ratings and Medicare Safety Penalty, the latter focused on hospital acquired infections. If you are interested in learning more, please email us at PAW@AmoryAssociates.com.
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[1] Medical Errors Are No. 3 Cause Of U.S Deaths, Researchers Say, May 3, 2016 NPR.org