Hospital ratings prescribe some patient relief but no cure-all
Compared to information readily available on most products and services, the quality reports hospitals will soon release are embarrassingly sparse. While consumers can evaluate how cars perform, from fuel mileage to repair problems, hospitals announced this month that they would provide data on how well they handle just three health conditions. And the quality measures are pretty basic, such as whether hospitals give heart-attack victims aspirin. Even then, the data won't be available until next summer, and hospital participation is voluntary.
For the health-care industry, however, the move is a giant leap forward. Patients are often forced to navigate in the dark, with almost no access to quality data that would let them pick the best hospital or doctor. The lack of uniform measures has produced a health system with wide variations in reliability that, as the Institute of Medicine reported last year, cost thousands of patient lives each year.
The dearth of information is particularly intolerable as health care moves rapidly toward a consumer-driven model that increasingly puts the burden on patients to choose providers and pay for care out of pocket. Yet, while hospitals are at least taking initial steps to better inform consumers, doctors for the most part remain resistant to the idea that they should be graded on quality to help patients choose the best care.
Last year, for example, doctors in Cincinnati opposed efforts by National Research Corp., an independent health-care evaluation firm, to rate them using patient surveys. They claimed the ratings were flawed, according to the American Medical News.
And AMA President Yank Coble complained recently about "the many ill effects of physician profiling," which would let consumers compare doctors based on quality care and patient satisfaction. Doctors say such ratings can be misleading: A physician who treats lots of complicated illnesses, for example, might look bad on measures that track patient outcomes. But technology has overcome such concerns by adjusting for the type of patients doctors treat to make fair comparisons possible.
Some comparative reports already are emerging despite physician opposition:
- National Research has patient satisfaction ratings for primary care doctors in Cincinnati and Portland, Ore., on its doctorguide.com Web site. BestDoctors.com directs patients to quality specialists for a fee.
- In Florida, business groups are teaming to collect insurance-claims data and patient surveys to assign physicians platinum, gold or silver ratings. The report cards will be publicly available in a year, according to the Central Florida Health Care Coalition.
- California's HealthNet is working on doctor ratings for its members, which will be up and running early next year.
While commendable, these regional efforts are only a partial solution. What's needed is an accelerated push by the federal government for national ratings. The Health and Human Services Department last month started publishing nursing home ratings. It plans to expand that to home health care next year, and eventually turn to hospitals and then doctors. The sooner the better.
Before patients can be expected to better manage their own health care, they must have solid data on physician quality. Doctors shouldn't keep them waiting any longer.