Hanys Issues "Report Card" On Hospital Report Cards

Main Category: Public Health
Article Date: 29 Apr 2008 - 4:00 PDT

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The Healthcare Association of New York State (HANYS) issued a unique study that assesses and scores eight prominent government, not-for-profit, and for-profit hospital quality reports. HANYS' review enlisted health care practitioners and quality experts from across the state, and found that just three of the eight major hospital quality reports scored better than a "B." Only governmental reports scored an "A."

"Patients, policymakers and practitioners all agree that reliable, accurate, and consistent quality measures are essential elements in improving health care services," HANYS' President Daniel Sisto said. "However, more and more entities are entering the quality measurement field, generating an avalanche of varied scoring that instead of assisting patients and providers, serves more to bewilder them."

Currently, several organizations issue grades or report cards on hospital quality. Each uses a different approach, which generates varied scores for the same hospital, leaving it unclear to the public what scores, if any, are accurate indicators of quality. HANYS' analysis for the report, entitled Understanding Publicly Reported Hospital Quality Measures, was conducted in 2007.

Hospitals have a keen interest in these reports, employing them routinely as tools to measure their performance and aid in their ongoing quality improvement efforts. However, these reports are often impossible to replicate for internal analysis and difficult to interpret and align with internal hospital quality improvement efforts due to the wide variation of scores and methodologies. As a result, they can waste limited hospital staff time and financial resources.

"What hospitals and patients need and deserve is a standardized, accurate, clinically-based method of measuring and comparing hospital quality. Right now we don't have that," Mr. Sisto said. "This study provides a critically needed analysis that we hope will serve as a first step toward providing consistent and understandable comparative information about hospital quality."

The complete report is available here.

The attached chart scores eight prominent hospital report cards:

- HealthGrades, a for-profit organization;
- Centers for Medicaid and Medicare Services (CMS);
- New York State Department of Health;
- The Joint Commission, a not-for-profit health care improvement entity;
- Leapfrog Group, a not-for-profit group;
- Niagara Health Quality Coalition on Hospital Quality, a not-for-profit group;
- Solucient, a for-profit group; and
- U.S. News and World Report, a for-profit news magazine.

Each report is scored on the following criteria:

- Complete Methodology Transparency - Is the complete methodology available, enabling hospitals to replicate and analyze internally?

- Risk Adjustment - Is a statistical model applied to the data that adjusts for significant differences in patient illness severity?

- Structure or Process Measures - Are there measures that rate key process steps or contributions to the end result?

- Outcome Measures - Do the data include measures of the end result of the patient care in addition to services provided?

- Most Current Data - Does the report use the most current data available?

- Data Consistency - Were comparative data points gathered from the same sources and timeframes?

- Measures Aligned with Recognized and Major Programs - Are the measures National Quality Forum-approved and/or aligned with federal CMS measures such as Hospital Quality Alliance?

- Hospital Review - Are hospitals allowed to review the report prior to release to correct potential uncontested errors?

HANYS, the only statewide hospital and continuing care association in New York State, represents more than 550 non-profit and public hospitals, nursing homes, home care agencies, and other health care organizations.

HANYS