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Connecticut Hospitals Beat National Average On Quality

By ARIELLE LEVIN BECKER

July 08, 2010

The federal Centers for Medicare & Medicaid Services released new data on a range of health care quality measures Wednesday, part of a website meant to help consumers compare hospitals.

The website, Hospital Compare, offers information based on Medicare claims and enrollment data and data submitted by hospitals. The new information includes measures related to outpatient care and the use of medical imaging such as MRIs and CT scans, intended in part to give patients a sense of how facilities use tests that can expose them to radiation. The website also includes data on inpatient care.

On average, Connecticut hospitals performed better than the national average in nearly all measures, which include the number of minutes before outpatients with chest pain get an electrocardiogram, the percent of outpatients who receive an antibiotic in the hour before surgery, and how frequently patients receive double CT scans when a single one might suffice.

"Our goal here is not to label hospitals as good or bad, but it's to provide insight to the hospitals as well as the general public on what they are achieving in the care that they render through Medicare and other programs, and we are encouraging them to improve on those results," Dr. Barry Straube, Centers for Medicare & Medicaid Services' chief medical officer, said during a conference call with reporters.

The new measures include:

- The portion of outpatients with low back pain given an MRI without first trying physical therapy or other recommended treatments. Too high a percentage could suggest the hospital does too many unnecessary MRIs for lower back pain, according to Hospital Compare. Connecticut's average — 26.9 percent — was below the national average of 32.7 percent. Milford Hospital had the lowest rate — 19.7 percent — while New Milford Hospital topped the chart at 34.5.

- The average number of minutes it takes for outpatients with chest pain or a possible heart attack to receive an electrocardiogram. Nationwide, the average time is 43 minutes; in Connecticut, it's 19 minutes.

- The portion of outpatients who received a follow-up test within 45 days of having a screening mammogram. Too low a percentage could suggest the hospital could possibly miss signs of cancer, while too high a number could suggest too much unnecessary follow-up, according to the website.

Other measures include data from patient surveys, mortality rates, the rates at which patients are readmitted to the hospital, and "process of care" measures, practices — like giving heart attack patients aspirin at discharge — that can lead to better outcomes.

The data can be useful for patients and family members making decisions about medical care, Connecticut Hospital Association officials said. Jane Deane Clark, the association's vice president for data services, recommended that people look at a wide range of data, rather than at a single indicator.

"The more you look at, the more you understand the data, the better off you are, rather than trying to narrow it down to one specific thing," she said.

While hospitals use larger sets of data to evaluate and improve their own performance, Dr. Jamie Roche, vice president for patient safety and quality at Hartford Hospital, said the public reporting of information can increase a hospital's focus on particular practices. Hospital Compare reflects an evolution toward the use of publicly reported data, something that is expected to increase under the health reform law, he said.

Hospital officials described the data on the website as a snapshot that patients should consider in context, along with other information.

"It certainly doesn't take the place of the physician-patient relationship," said Gregory Makoul, senior vice president for innovation and quality integration at St. Francis Hospital and Medical Center. "But it's an additional piece of information."

Ann Marie Capo, chief quality officer for the UConn Health Center, which includes John Dempsey Hospital, said the compare website can give patients information, but the data itself might not explain reasons for variations. For example, some hospitals, including Dempsey, might perform more double CT scans because they see patients with more complex needs, she said.

For prospective patients, Capo suggested talking to other patients to find out how they were treated, whether their needs were met, whether their regular doctor knew they were there and what was done to them and how well they made the transition to the next stage of care.

"If I was going to have surgery, I would want to also look at how transparent is an organization, how willing are they to share mistakes they've made as well as the good news of what they are doing," she said.

The Hospital Compare website is: http://www.hospitalcompare.hhs.gov. Data are also available on the Connecticut Hospital Association website, http://www.cthosp.org, under the heading "Quality and patient safety info for patients and their families."