The measurements for quality among hospitals listed in six publicly available hospital comparison websites are incomplete or inappropriate, and giving readers inconsistent results, according to an article published in Archives of Surgery (JAMA/Archives), September issue.
The article explains how the internet has grown as a source for health information, with 113 million Americans accessing the internet for health information in 2006. Almost one third of those people carried out searches on specific hospitals and doctors, the authors write. While the public and insurance companies keep pushing for more transparency and accountability in health care, online data on hospital performance has never been comprehensively examined by researchers.
Michael J. Leonardi, M.D., David Geffen School of Medicine at UCLA, Los Angeles, and team carried out a systematic internet search in 2006 September to find publicly available quality comparison web sites. They identified six different sites and rated them according to accessibility, transparency of data and statistical calculations, appropriateness, consistency and timelines.
The researchers identified six web sites:
— Hospital Compare (from the Centers for Medicare and Medicaid Services – government run)
— Quality Check (Joint Commission on Accreditation of Healthcare Organizations – non-profit)
— Leapfrog Group’s Hospital Quality and Safety Survey Results (non profit)
— Three more private and proprietary ones
The authors explain “For accessibility and data transparency, the government and non-profit Web sites were best. For appropriateness, the proprietary Web sites were best, comparing multiple surgical procedures using a combination of process, structure and outcome measures. However, none of these sites explicitly defined terms such as complications.” The writers also said that none of the sites had data which was less than 12 months’ old.
The researchers carried out sample searches on the three proprietary web sites comparing four area hospitals in Los Angeles. The searches were carried out on three common procedures – laparoscopic gall bladder removal, hernia repair and colon removal. Here, they found major contradictions – two sites ranked one hospital as best for colon removal, while another site ranked the same hospital as the worst (for colon removal).
The researchers conclude “Further work is needed to improve these issues, particularly the accessibility by patients, the quality and type of data reporting, the statistical method and the criteria by which hospitals and specific operations are compared. It is probably important that surgeons be involved with the development of such reporting Web sites so that the comparisons accurately and appropriately reflect the quality of surgical care.”
Arch Surg. 2007;142(9):863-869
Written by: Christian Nordqvist