Review: Comparing Quality of Care at HospitalCompare.com

“You can put your clothes back on,” the doctor says as he walks out. Before you know it, he’s back and you’re still hopping around the cold floor, aiming for your pant leg and with your sweater on backward. There’s no time for embarrassment, because the doctor declares that you need surgery. You don’t remember finishing dressing or half of what the doctor told you, and now it’s too late to ask, “Can you run that by me again?”

If you can relate to this scenario, here’s something you can do. Get off the couch and onto the internet, type “hospital compare” in your web search field, and you’ll find a web site of the same name , Hospital Compare (www.hospitalcompare.hhs.gov [1] ), with quality performance information regarding selected clinical topics from more than 4,000 U.S. hospitals. The information on this web site is intended to help you when you talk with your health care provider and to enable you to make informed decisions.

Although the web site is provided by the U.S. Department of Health & Human Services (HHS), Hospital Compare was created through the Hospital Quality Alliance (HQA) to provide credible information to the public regarding the quality of care in hospitals and to encourage efforts for improvement.

Hospital Compare allows people to compare some of the most common conditions (i.e., heart attacks, pneumonia, etc.), surgical procedures, mortality rates, pediatric asthma data, and the quality of medical care that hospital patients receive.

Soon, it will be possible to compare care received in hospital outpatient settings. Information is expanding to include steps taken to prevent blood clots and surgical site infections, plus coverage on hospital admission rates. Because the web site is hosted by the HHS, it also includes information regarding Medicare coverage.

The initial search is done by choosing the mileage radius from a zip code, city, state/territory, or county; or search by hospital name. Then it's possible do a general search or search by a specific medical condition or surgical procedure.

The site does a great job on the results page regarding the content, the table layout, and the interactive map with directions and distance to starting point. You can compare up to three hospitals by selecting the checkboxes to the left of the hospital names. You can reselect your choice of hospitals and sort the table by the hospital name, hospital type, and distance. I liked that you could “modify your search” and “change condition or procedure” without having to start from scratch. The site is very forgiving in allowing you to go back and forward through several screens without kicking you out all together. However, I couldn’t get the map (with seven hospitals on it from my comparison) to print out nor could I make a pdf file of the map. That may be a MapQuest problem.  The results table includes:

• Hospital name, address, etc. and hospital type (e.g. acute care—inpatient)
• Whether it provides emergency services
• Hospital process of care measures (percentage how often a health care provider gives  treatment known to give the best results for most patients with a particular condition)
• Hospital outcome of care measures (measures to reflect the results of care, rather than how frequently a specific treatment or intervention was performed)
• Survey of patients’ hospital experiences (a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay.
• Average Medicare payment to hospital
• Number of Medicare patients treated (total for the United States and total for the state specified in the initial search criteria) 

The last two items listed above also provide the diagnosis related group (DRG) code used. DRGs are the diagnosis codes doctors and hospitals put on patient’s medical bills that Medicare uses to decide how much to pay the hospital

Comparisons involve the most commonly treated conditions and surgical procedures in hospitals. You can first view lists for the surgeries or conditions before making your next selection.

The medical conditions include:

• Heart attack
• Heart failure
• Chronic lung disease
• Pneumonia
• Diabetes in adults
• Chest pain

The surgical procedures include drop-down menus of specific operations for the following areas of the body:

• Heart and blood vessels
• Abdominal
• Neck, back, and extremities (arms and legs)
• Bladder, kidney, and prostate
• Female reproductive

The site is user-friendly and layout of the results page is easy to understand. However, if you don’t need Medicare coverage, all of the Medicare information can be distracting.

Even if you are interested in the Medicare data, there was too much information to choose from (or remember) and it was easy to get lost in the many drop-down menus. There were results with codes but no explanation of the measurement criteria or what the codes meant, and some of the footnotes were confusing.

If you want more information to further explain your comparison results, you can download files on the diagnosis codes, mortality rates, quality measures, and the complete survey of patients’ hospital experiences, also referred to as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

There’s also advice and contact information if you wish to complain about the quality of medical care received at a hospital.

Summary

The Hospital Quality Alliance was launched in 2002. HQA members include physicians, nurses, other health care organizations, federal agencies, consumer and business groups, and quality experts. The HQA believes that public accessibility and use of hospitals’ performance information incite improvement in health care delivery.

Hospital Compare was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), the HHS, and members of the HQA, all of whom share a vision for improving the care hospitals provide.

Talk to your physician or local hospital staff; ask what the information that you find on this web site means and how it can be used to make informed health care decisions.