Hospital readmission rates misleading

Hospital readmission rates misleading

From the Healthcare Informatics blog item

Readmission rates, for instance, do not take into account the complexity of correcting problems involving the spine, which often call for two or more staged surgeries spaced out over several weeks, says Mummaneni. Publicly reported readmission rates do not always take into account scheduled follow-up surgeries and unplanned hospital readmissions, causing the calculated rates to be over-estimated. Additionally, he said, this problem may present surgeons with a tough choice between scheduling multiple surgeries, which may be better for the patients, and scheduling single surgeries, which would improve readmission rate calculations.

A US Navy general surgeon and an operating room nurse discuss proper procedures while performing a laparoscopic cholecystectomy surgery. (Photo credit: Wikipedia)

Related articles

• Readmission rate could be not as relevant as it seems in measuring hospital’s performance (philippehavinh.wordpress.com)
• Hospital readmission rates misleading (eurekalert.org)
• Spinal Surgeries Much More Successful Than Reflected In Public Reported Statistics (medicalnewstoday.com)
• New tool allows hospital performance comparisons (cbc.ca)
• Reducing Hospital Readmissions (fedmark.wordpress.com)
• New Metrics for Health Care Reform (3mhealthinformation.wordpress.com)
• Simple, but wrong, approach on readmissions (thehealthcareblog.com)
• Is the hospital readmission rate a measure of quality? (kevinmd.com)
• New Study Shows EHR Can Help Reduce Hospital Readmissions (jaysimmons.org)
• Most Triad hospitals again face Medicare penalties for readmission rates (bizjournals.com)

 

Mapping the Quality of Care From Hospitals and Doctors

Image via Wikipedia

From the 28 June 2011 Wall Street blog item by Katherine Hobson

How’s the diabetes treatment in Wisconsin? Or the access to after-hours medical care in California?

The Robert Wood Johnson Foundation has rolled out a new online directory** of 224 health-care quality reports that compare local physicians and hospitals.

The idea is that consumers can get localized, quantitative information on measures such as how often patients in a certain medical practice receive their recommended screening tests or how long mothers typically spend in a given hospital after a cesarean section. The specific measures will vary by report.

Note the emphasis on “quantitative.” These reports, 197 of which cover specific states, all use performance data based on nationally recognized standards on quality and cost. All are freely available. The more subjective picture offered by sites such as RateMDs.com or Yelp aren’t on the map….

…The reports mainly focus on quality; the cost of health-care services is tougher to measure, says Painter. For example, are you looking for the price that would be charged to a patient, the cost breakdown of certain elements of care or something else? Some reports do include cost data; we’ve written separately about sites that tackle the cost issue…

**For example, go to  Comparing Health Care Quality: A National Directory to compare hospital data in Ohio

• Click on the state of Ohio in the interactive map, then click on View these (Ohio) resources
• Click on View Report to the left of  the Ohio Department of Health (one higher in the list)
• Use the options to select counties, hospitals, locations to find out information about one or more hospitals

You can also select one or more quality measures for one or more hospitals (as infection prevention, heart failure, knee
surgery)

Related Resources (from the Comparing section of  the Tulane University Health Management LibGuide***)

• 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
• HealthGrades –   A healthcare ratings organization, providing ratings and profiles of hospitals, nursing homes and physicians to consumers, corporations, health plans …

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A more general resource for health information and much, much more

LibGuides are free topic specific guides to Web sites and books by library specialists.

Currently  one can “Search and explore 168,085 guides by 32,658 librarians at 2269 libraries worldwide!”

Library types include academic, public, and K-12.

Have a topic or subject in mind? There is most likely a related library guide in the LibGuide collection.Related articles

• Comparing Health Care Quality: A National Directory (aa47.wordpress.com)

• New HHS Program Incentivizes Hospitals for Quality of Care Not Quantity of Service (extendhealth.wordpress.com)
• PolicyMap will present on retail-based healthcare at the Health Data Initiative (HDI) Forum on June 9! (policymap.com)

Related Articles (for Mapping the Quality of Care from Hospitals and Docs)

• Hospital Referral Program May Not Improve Surgery Outcome (nlm.nih.gov)
• Hospital Compare data may not help surgical patients find hospitals with better outcomes (AHRQ, Oct 2010)
• Referral to high-volume hospitals for operations fails to improve outcomes statewide (eurekalert.org)
• 1 in 3 patients harmed during hospital stay (kboreilly.com)

First Glimpse at [Publicly Available] Medical Error Rates Separates the Good, the Bad and the Ugly

From the report by the Sunlight Foundation Reporting Group

By Sarah Dorsey Apr 25 2011 11:28 a.m.

Between Oct. 1, 2008 and June 30, 2010, Medicare patients at St. Joseph’s Medical Center in Yonkers, N.Y., suffered thirteen instances of severe bed sores during their stay requiring additional treatment, a rate of nearly 2.9 per 1,000 treated. At St. John’s Riverside Hospital, three miles down Broadway from St. Joseph’s, the rate was 20 times lower: only one severe bed sore was reported, even though St. John’s discharged far more Medicare patients during that period — 8,270 to St. Joseph’s 4,541.

Over the protests of groups like the American Hospital Association, Medicare officials this month publicly revealed for the first time where harmful events like these took place. In addition to bed sores, the data includes information on trauma and falls, infections and the egregious errors known as “never events,” such as patients being given the wrong blood type, or foreign objects being left in the body after surgery.

As many as 98,000 Americans are thought to die annually from medical errors, and about as many succumb to infections they picked up during a hospital stay, according to oft-cited figures released a decade ago, but new research published last week suggests that “adverse events” like these occur about 10 times as frequently as previously thought, in about a third of all hospital stays.

Click on each incident type for a sortable spreadsheet with detailed information on each hospital….

(Clickable Table follows in this report, with additional text)

…While the numbers aren’t perfect, they’re a first-ever attempt by Medicare to publicly report patient safety data on individual hospitals. For the first time, the public can get a general idea of how many Medicare patients are sent home with conditions acquired in the hospital.

Related Articles

• Hospital costs, safety data helpful but limited (medcitynews.com)
• New Study Finds Medical Error Rates are Underreported (worku.wordpress.com)
• 1 in 3 patients harmed during hospital stay (kboreilly.com)
• Despite Efforts, Study Finds No Decline in Medical Errors (jflahiff.wordpress)
• Ending unnecessary medical errors means major political, hospital reforms (medcitynews.com)
• Report: Hospital Errors May Be Far More Common Than Suspected (nlm.nih.gov)
• Hospital Safety Varies Widely Nationwide (nlm.nih.gov)

HCUP Facts and Figures: Statistics on Hospital-based Care in the United States

HCUP Facts and Figures 2008 Statistics on Hospital-Based Care in the United States, 2008

The number of patients who needed home health care after being discharged from hospitals surged by about 70 percent (2.3 million to 4 million) from 1997 to 2008.  [Source: Agency for Healthcare Research and Quality, HCUP, HCUP Facts and Figures, Statistics on Hospital-Based Care in the United States, 2008.]

Some highlights from HCUP Facts and Figures: Statistics on Hospital-based Care in the United States, 2008 

OVERVIEW STATISTICS FOR INPATIENT HOSPITAL STAYS	EXHIBIT
The number of hospital discharges increased from 34.7 million in 1997 to 39.9 million in 2008, a 15-percent increase overall, or an average annual increase of 1.3 percent.	1.1
Between 1997 and 2008, the aggregate inflation-adjusted costs for hospitalizations—the actual costs of producing hospital services—increased 61 percent. Costs rose from $227.2 billion to $364.7 billion—an average annual increase of 4.4 percent.	1.1
The average length of stay (ALOS) in 2008 (4.6 days) was almost 20 percent shorter than in 1993 (5.7 days). The ALOS declined throughout most of the 1990s and has remained unchanged since 2000.	1.2
Circulatory conditions were the most frequent major cause of hospital stays in 2008, accounting for 5.9 million stays or 15 percent of all discharges.	1.3
Even when pregnancy and childbirth stays are excluded, females accounted for more stays than males—18.6 million stays for females compared to 16.5 million stays for males.	1.3
Pregnancy and childbirth was the reason for 1 out of every 5 female hospitalizations (4.7 million stays).	1.3
Medicare and Medicaid were the expected primary payers for more than half (55 percent) of all inpatient hospital discharges.	1.4
Between 1997 and 2008, Medicaid discharges (up 30 percent) grew at double the rate of all discharges, followed closely by uninsured discharges (up 27 percent).	1.4
The number of discharges billed to Medicare grew by 18 percent.	1.4
Growth in the number of discharges billed to private insurance remained relatively stable (5 percent).	1.4
The number of discharges to home health care grew by 69 percent (1.6 million discharges) between 1997 and 2008.	1.5
Uninsured and Medicaid stays accounted for nearly half (48 percent) of all stays discharged against medical advice, but only about one-quarter (23 percent) of all stays in 2008.	1.5
Persons residing in the poorest communities had a 21-percent higher rate of hospitalization in 2008 (148 discharges per 1,000 population) than those residing in all other communities (122 discharges per 1,000 population).	1.6