The Family Health Guide

How good is your hospital? - Harvard Health Publications

How good is your hospital?

Sooner or later, most of us spend some time in a hospital. In an emergency, you don't have much choice: rush to the closest one. For conditions that get worse more slowly—for example, an episode of slowly worsening heart failure—or for a planned procedure like bypass surgery, however, there is time to look at the options.

The hospital you wind up in is usually determined by the doctor you choose to be in charge of your care in the hospital. But there are two reasons you may want to do a little homework about your choices in hospitals. First, some doctors admit patients to more than one hospital. Second, in choosing a doctor, the hospital that doctor uses may enter into your choice.

Traditionally, people checked out hospitals by talking to their doctor, family and friends. That's still a good idea. But today you can also check an online Web site that contains hospital quality data.

Just the facts

The most famous hospital "report card" is the annual America's Best Hospitals list assembled by U.S. News and World Report. It covers the top 50 hospitals in different categories of care.

Several Web-based hospital quality databases cover more hospitals than the Best Hospitals list and let you look at hard data on deaths and readmissions.

Your first stop should be Hospital Compare. This Web site, run by the U.S. Department of Health and Human Services, provides information on how well hospitals care for patients with heart attacks, heart failure, pneumonia, or other conditions, or who need one of almost 30 procedures, ranging from angioplasty and pacemaker implantation to gallbladder surgery and hip replacement. (hospitalcompare.hhs.gov)
For example, you can see how the hospitals in your area fare on 30-day re-admission —

the percentage of patients who need to be hospitalized again within 30 days of being discharged. The lower the rate, the better, of course, though what patients do, or don't do, after being discharged also affects readmission rates. Other hospital rating sites include:

  • The Leapfrog Group was started by large employers to improve the quality of hospital care and reduce errors. Participation is voluntary, so not every hospital is in the organization's database. (www.leapfroggroup.org)
  • Quality Check is sponsored by the independent Joint Commission, which accredits and certifies more than 17,000 health care organizations and programs in the United States. Information from this process is used to create reports on hospitals. (www.qualitycheck.org)
  • HealthGrades is a Colorado-based company that independently rates medical providers nationwide. It gives hospitals one, three, or five stars for 28 common procedures and conditions, such as valve replacement surgery and pancreatitis. The stars are based on death and complication rates. (www.healthgrades.com)

None of these systems is perfect. For example, hospitals that treat sicker people, like trauma centers, tend to have higher mortality rates than those that treat a more "regular" population, even though the trauma centers may deliver superior care. So think of ratings as just a useful piece in the puzzle.

February 2010 update

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