Hospital readmission rates linked to availability of care, socioeconomics

From the 11 May 2012 Eureka News Alert

American Heart Association meeting report – Abstract 12

Differences in regional hospital readmission rates for heart failure are more closely tied to the availability of care and socioeconomics than to hospital performance or patients’ degree of illness, according to research presented at the American Heart Association’s Quality of Care & Outcomes Research Scientific Sessions 2012.

U.S. regional readmission rates for heart failure vary widely ― from 10 percent to 32 percent ― researchers found. Communities with higher rates were likely to have more physicians and hospital beds and their populations were likely to be poor, black and relatively sicker. People 65 and older are also readmitted more frequently.

To cut costs, the Centers for Medicare and Medicaid Services plans to penalize hospitals with higher readmission rates related to heart failure, heart attack and pneumonia. Next year, hospitals with higher-than-average 30-day readmission rates will face reductions in Medicare payments.

But the penalties don’t address the supply and societal influences that can increase readmission rates, said Karen E. Joynt, M.D., lead author of the study and an instructor at Brigham and Women’s Hospital, Harvard Medical School and the Harvard School of Public Health in Boston, Mass….

Related articles

• Hospital Readmission Rates Linked to Availability of Care, Socioeconomics (newsroom.heart.org)
• Availability of Beds, Poverty Drive Costly Hospital Readmissions (news.health.com)

To Gauge Hospital Quality, Patients Deserve More Outcome Measures One Comment

From the 15 February 2012 Health Care Blog item

Patients, providers and the public have much to celebrate. This week, the Centers for Medicare and Medicaid Services’ Hospital Compare websiteadded central line-associated bloodstream infections in intensive care units to its list of publicly reported quality of care measures for individual hospitals.

Why is this so important? There is universal support for the idea that the U.S. health care system should pay for value rather than volume, for the results we achieve rather than efforts we make. Health care needs outcome measures for the thousands of procedures and diagnoses that patients encounter. Yet we have few such measures and instead must gauge quality by looking to other public data, such as process of care measures (whether patients received therapies shown to improve outcomes) and results of patient surveys rating their hospital experiences….

Related Resources

• Hospital Quality Compare (Centers for Medicare & Medicaid Services)- compares quality of care for certain medical conditions at more than 4,200 hospitals. The site also includes a checklist to help you choose a hospital

• Leapfrog Hospital Ratings - information on this site is derived from hospitals’ voluntary submissions of The Leapfrog Hospital Survey. More about the Leapfrog Group at their About Page
  
• AHRQ (US Agency for Health Care Research and Quality
  • Consumer Page includes
    • Choosing Quality Health Care
    • Getting Safer Care
    • Comparing Medical Treatments
  • Clinical page includes
    • Outcomes and Effectiveness
    • Effective Health Care
      
• Medicare.gov includes
  • Home Health Compare
  • Nursing Home Compare

 

 

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• Doctor Rating Web Site Health Grades is a Time Magazine “Best 50″ – How Trustworthy Is the Content?? (jflahiff.wordpress.com)
• Georgia hospitals rated on infections (ajc.com)
• Hospital Reviews Reflect Data On Hospital Outcomes (medicalnewstoday.com)
• The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality (bespacific.com)
• Surgical Outcomes-Based Measures Developed: Approval Marks Latest Step In Path To National Implementation (medicalnewstoday.com)
• The Leapfrog Group names Children’s Memorial a top children’s hospital for patient safety (prweb.com)
• The Leapfrog Group Names Virginia Mason Top Hospital of the Decade (prweb.com)
• Roswell Park Named to Leapfrog Group’s Annual Top Hospitals List (prweb.com)
• How patient satisfaction can kill (kevinmd.com)
• American Health Care System Gets Positive Prognosis In “U.S. Health Care: The Good News” February 16, 2012 At 9 P.M. Est On PBS With Correspondent T.R. Reid (prweb.com)
• National Quality Forum endorses 2 American College of Surgeons NSQIP measures (eurekalert.org)
• Skeptical Scalpel: Patient satisfaction and reality (gruntdoc.com)
• Nurse Navigators Providing Patient Satisfaction at Medical Center (prweb.com)
• Hospital Caregivers use MagnaSnap Paper Clamps at Bedside to Improve Patient Satisfaction Scores (prweb.com)
• Requiring doctors to give orders on patients they have not seen (kevinmd.com)

Doctor Rating Web Site Health Grades is a Time Magazine “Best 50″ – How Trustworthy Is the Content??

HealthGrades has been rating doctors, dentists, and hospitals on five star scales for over ten years. Ratings include communication skills, time spent, trust, and office environment. There are also links to board sanctions.

This past August Time Magazine rated Health Grades as one of the 50 best Websites of 2011.

Recently there was a lively discussion on this topic at the medical librarian listserv (Medlib-L).
Among the responses…

• Two people noted contact information for their doctors was not correct
• “The self selection process creates a huge bias. The people who are angry and disappointed are the ones motivated to write.”
• “patient rating is 4.5 stars out of 5, but he’s only had 4 patients comment on him. In skimming through other doctors in Fargo, very few have more than 4 patient comments and everyone has between 4 and 5 stars.”
• “My doctor is in private solo practice and when you look at the lists by highlighted or popularity they are very institutionally presented. The independents come at the end of the list so this is not a fair representation”
• “the physician she replaced upon his retirement in April 2008 is still listed (with one review), although he has been gone for almost 4 years”

Although these comments do not compromise an in depth critique of Health Grades they do raise questions about its currency, contact information correctness, and basis of comparison (basically unsolicited input from patients). It would be wise to use Health Grades in conjunction with other sources of information to make good decisions on choosing or evaluating a doctor, dentist, or hospital.

Some additional sources of information

• Leapfrog Group Hospital Quality and Safety Survey  compares” hospitals’ performance on the national standards of safety, quality, and efficiency that are most relevant to consumers and purchasers of care”
• The CAHPS Hospital Survey  -Centers for Medicare & Medicaid Services, programs and information.
• Hospital Compare - A quality tool provided by Medicare
• Comparing Health Care Quality: A National Directory (Robert J. Woods Foundation) -Web-based resources to help them choose a doctor or hospital in their town based on whether patients received recommended tests and treatment, the outcomes of their care, their experience with providers, or the overall cost of care. Not comprehensive, geared mostly to large urban areas.
• Choosing a Doctor or Health Care Service (Medline Plus) includes numerous resources on  how to find a specific doctor and general guidelines
• State Medical Boards usually provide only the basics: contact information, specialties if any, and any formal actions

Related articles

• Patients’ Grades to Affect Hospitals’ Medicare Reimbursements (nytimes.com)
• Medicare launches ‘hospital compare’ (seattletimes.nwsource.com)
• Isn’t it time for a patient rating system for doctors? (kevinmd.com)
• HealthGrades to Merge with CPM Marketing – Will Their Data and Questionable Algorithms Will Be Improved For Consumers? (ducknetweb.blogspot.com)
• Social Media Physician Referrals – Whichdoc Recommends Doctors Using Facebook (TrendHunter.com) (trendhunter.com)
• Limits to the Active Health Care Consumer (josephineensign.wordpress.com)