With a revamped quality ranking system, Healthgrades takes its place among other groups scoring hospital safety and quality of care: Leapfrog Group, Consumer Reports, U.S. News & World Report, Truven, and Hospital Compare
Quality of care at 4,500 U.S. hospitals is being sliced, diced, scrutinized, and ranked yet again with a new and significantly expanded quality ranking system from Healthgrades.
This time the Denver-based company, which has provided quality information about healthcare providers for 14 years, offers state-by-state analysis online for up to 28 types of care, 13 safety measures, and five-year trends for four conditions.
"We've organized this information with a convenient set of tools to help consumers select and filter hospitals based on their particular requirements: proximity, insurance coverage, clinical ratings, patient satisfaction, and safety in a relatively easy to use interface," says Evan Marks, Healthgrades editor. "Getting this information from other sites may be more difficult."
The report, American Hospital Quality Outcomes 2013: Healthgrades Report to the Nation, uses data purchased from MedPAR, the Centers for Medicare & Medicaid Services Medicare Provider Analysis and Review between 2009 and 2011. The data represents a three-year rolling average.
After applying its algorithms to the data, Healthgrades gives hospitals one, three, or five gold stars on up to 28 types of care—from appendectomy to pulmonary embolism to valve repair—to indicate whether patient outcomes of were worse than expected, as expected, or better than expected.
Marks says that about 70 percent of all hospitals fell into the middle three-star category, 10-15% fell into the five-star category and 10-15% fell into the one-star category, depending on the type of care provided.
Additionally, hospitals may receive awards for special excellence, granted for those conditions for which a hospital received five stars.
A quick glance down a list of all hospitals in one region of the country indicates that most hospitals received at least one award but a few hospitals didn't receive any because they did not score high enough on any particular type of care.
On the other hand, Mayo Clinic Saint Mary's Hospital in Rochester, MN received 14 five-star ratings and 12 quality awards.
The Healthgrades report is one of about six major national sources for consumers and providers to compare quality in healthcare. Others include the Leapfrog Group, Consumer Reports, U.S. News & World Report, Truven, and Hospital Compare.
Healthgrades has also introduced an evaluation, based on a telephone survey, of how consumers in 27 cities make decisions about where to get care. In general, the survey found that people spend more effort choosing a refrigerator than they do choosing a doctor or a hospital.
"Individuals always have a choice, yet we found that the way they're making that choice focuses on convenience rather than any objective information on quality," says Archelle Georgiou, MD, Healthgrades' strategic advisor. In fact, she adds, "only 50% of people surveyed were even aware that objective quality information (about their healthcare providers) was even available, and only about one third of those used it to make a decision."
Only a portion of those said that they were happy with the decision they made, she says.
The information throughout the hospital portion of the site, as well as previously published Healthgrades information on physician and dentist practitioners, is free. Healthgrades earns revenue from hospitals and individual providers who buy the right to use Healthgrades' awards and recognition for quality in their marketing and advertising materials and in their news releases.
For the first time the Healthgrades report ranks states by average risk-adjusted mortality rates. The top five states are Arizona, Montana, Colorado, Wisconsin, and Minnesota. The bottom five states are Alabama, Washington, D.C., Mississippi, Nevada, and Vermont. But the report also shows wide variation among hospitals just moments away from each other within the same city.
Additionally, a color-coded chart in the report shows average risk-adjusted in-hospital mortality by state. Special reports outline key quality measures for each of 50 states plus the District of Columbia.
Another new feature includes a chart showing that in-hospital mortality rates for four conditions and procedures over the last five years. For example, it shows that between 2005 and 2007, mortality rate for sepsis was 22% but declined to 17.3% by 2009-2011. Likewise, mortality for heart attack patients declined from 10.3% in 2005-2007 to 7.5% in 2009-2011.
Marks says that unlike some other national healthcare scorecards, Healthgrades has avoided producing an actual ranking of states throughout the country in overall quality, saying it would be "forced" because the margin of error between a ranking of 46 and 47 may be insignificant.