Federal Website Rates Hospitals on Treatments

The federal government unveiled a rating system Friday comparing how well 4,200 hospitals nationwide treated three of the most common medical conditions: heart disease, heart attacks and pneumonia.

The Hospital Compare website -- part of an effort to provide the public with better information about healthcare quality -- rates individual hospitals by comparing how often patients get the right care according to basic guidelines.

The website, put together by the U.S. Centers for Medicare and Medicaid Services -- shows how well each hospital performs against state and national averages.

Overall, Southern California hospitals surpassed national averages in some categories, but fell behind in others.

Ninety-four percent of hospitals in Southern California, for example, followed treatment guidelines by giving heart attack patients aspirin on arrival, compared with 91% nationwide.

But 22% of Southern California hospitals provided pneumonia patients with a pneumococcal vaccine, a guideline followed by 43% nationwide.

Among the hospitals in the region, differences tended to fall along familiar lines. Well-known, better-funded hospitals such as Cedars-Sinai and UCLA Medical Center performed above state and federal averages in many categories. Poorer hospitals tended to fare worse.

Kaiser Permanente provided limited data for the survey. The company said it hadn’t yet fully collected the data but expected to report more information this year or early next year.

Healthcare experts said the new information was a good first step toward providing consumers information that had not been available.

By comparing hospitals, the quality initiative should give doctors and hospital administrators incentives to improve their performance.

“Consumers are pretty much in the dark right now,” said Dr. Don Berwick, president of the Institute for Healthcare Improvement, a patient quality group in Boston. “They don’t have a lot of information on hospital performance.”

The new federal website is limited, he said, but “it is better than nothing.”

The limitations include the website’s restriction to the three medical conditions and the sorts of comparisons used. Federal officials said they hoped to expand the list over time. Rather than looking at broad, hospitalwide statistics such as death or infection rates, the website details up to 17 specific procedures in each -- how frequently heart attack patients are given aspirin, for example.

The new tool comes amid a national push to improve the quality of healthcare by giving patients more comparative data about health plans, nursing homes, doctors and hospitals.

A significant gap exists between the best practices defined by medical experts and the care provided by many doctors and hospitals, healthcare experts said.

“Quality of care can vary considerably across hospitals,” Dr. Mark McClellan, administrator of the federal Medicare agency, said in an interview. “This gives consumers and health professionals reliable information that they can use to make healthcare decisions.”

Peter Lee, president of Pacific Business Group on Health, an employer coalition, said the new reporting system would help consumers because it would provide the first consistent national standards on commonly used medical treatments.

“People want to know what kind of track record their hospitals and doctors have before they get care,” he said. “This is a small step toward giving them that.”

In a study last year by the Blue Cross Blue Shield Assn., 78% of people said they would want to know if their medical provider complied with established treatment guidelines.

The data for the website was submitted by nearly all hospitals that received reimbursement from Medicare, the federal insurance program for the elderly and disabled.

Under the 2003 Medicare Modernization Act, hospitals must share the data or get penalized 0.4% of their Medicare reimbursements, a significant sum of money.

The Medicare agency has previously unveiled similar Web tools to help consumers compare nursing homes and home health agencies. But, until this effort, hospitals had resisted such efforts.

The federal website joins a mix of ratings systems put together by state agencies, private companies, insurers and employers.

Those ratings often provide more information than Medicare’s but many use different rating standards, making comparisons difficult.

The federal agency is expected to update the free site, at www.hospitalcompare.hhs.gov.