When a patient decides to find a new physician or select a hospital for a surgical procedure, is he or she more likely to use government health quality data or data supplied by the health plan or employer?
The answer might be neither.
Despite "well-intentioned efforts" by these entities in recent years to advance healthcare price and quality transparency, most patients still choose physicians and hospitals based on recommendations from friends, families, and physicians, said Paul Ginsburg, PhD, president of the Center for Studying Health System Change, and research analyst Nicole Kemper in a recent commentary from the Center.
Even though wide-ranging evidence shows that the quality of U.S. healthcare is "uneven at best" and that Americans pay more for healthcare—with sometimes diminished results—in comparison with other industrialized nations, healthcare price and quality transparency in the U.S. for the most part "remains a product in search of a buyer," they said.
On the cost front, many patients have few incentives to look beyond price when selecting healthcare providers because they usually pay comparable amounts as long as those providers are within a network plan. On the data front, patients may feel indifferent toward information that lists most of the providers as "average" or lumps different services such as cardiovascular care or maternity care into one aggregated hospital measurement that masks variations in these programs throughout a hospital.
However, some changes are occurring at the local levels to make data more accessible—and more relevant, according to a separate briefing by Center researchers. One program they describe—CalHospital Compare, a Web site that was launched in March 2007—rates California hospitals on 70-plus performance measures, including process, outcome, and patient experience measures.
This site goes somewhat beyond the data, for instance, presented by the Center for Medicare and Medicaid Services' Hospital Compare, which at the current time applies to a limited range of conditions and procedures. Hospital Compare uses point estimates for measures—without specifically identifying if differences among provides are statistically significant. With the California site, a five-point scale is used, with multiple benchmarks, to specify an individual hospital's quality as poor, below average, average, above average, or superior.
Going online, patients are likely to encounter many types of data, for instance, about how people like their physicians or the office staff, said Steve Findlay, a healthcare analyst with Consumers Union, last week at a symposium in Washington on "Getting to a High-Value Health System." While that experience-of-care information is helpful, it falls short of providing more detailed comparative, high-quality data that they can link to their care.
"We haven't yet got to a place where this is easy for consumers to use. It's just simply not easy," Findlay said. "It's a conundrum. We [consumers] don't quite yet know what quality of care is or what quality measurements are."
Consumers Union addressed that dilemma in part this week by announcing a new program and Web site by which patients and consumers can look up patient satisfaction ratings to more than 3,400 hospitals across the country.
The data is being used to link patient satisfaction and quality of care issues: Consumers Union, the publisher of Consumer Reports magazine, is using the federal government's Hospital Consumer Assessments of Healthcare Providers and Systems Survey (better known as HCAHPS) and the Dartmouth Atlas of Health Care to view patients' views of their care.
Consumers Union found that hospitals that have above-average patient satisfaction had shorter hospital stays and more conservative care patterns.
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