Quality Care

By Christine Gorman, Sora Song

Where would we be without report cards? They help schools rank students--and, increasingly, teachers--and are used to evaluate everything from automobiles to laptops to corporate workplaces. But the medical profession has long been reluctant to publish specific data on infection rates, surgical complications or medication errors that would help the public decide which doctors or hospitals do a better job of caring for their patients.

The Federal Government's Centers for Medicare and Medicaid Services took a small but significant step toward greater medical transparency this month when they launched a new website hospitalcompare.hhs.gov that allows consumers to assess the care at any of nearly 4,200 hospitals across the U.S. for three conditions: heart attack, heart failure (a progressive weakening of the cardiac muscle's ability to pump blood) and pneumonia. The site is easy to use and is based on nationally accepted standards of care--although there are a few wrinkles you should know about.

First, the number of data points is limited, with just 17 variables to choose from. Some of the measures are easy to understand, such as the percentage of heart-attack patients who are given an aspirin when they first arrive at the hospital. Others are a little more obscure, such as the number of pneumonia patients "given initial antibiotic timing," which turns out to mean they got antibiotics within four hours of arrival.

There are no death rates, however, and some of the results seem to reflect sloppy paperwork more than anything else (e.g., did a doctor remember to record the aspirin given in the ambulance?). No doubt such mix-ups will soon sort themselves out. But one wonders whether publishing these data could have the unintended consequence of requiring medical staff to spend more time on documentation and less on treatment. Still, the possibility of improving the quality of health care--and perhaps cutting medical costs as well--seems worth the risk.