Health Care and Insurance and Technology

Hospital grades hit Web: State says data is helpful, but should be used carefully by health care consumers

January 10, 2005

Everything from the number of services performed to the number of complaints received is covered by the new hospital consumer reports section on the department's Web site.

Health Department officials say they've wanted to post this information for some time to give patients a way to make more informed choices about where to seek treatment. However, the people who post the numbers and others in health care caution that the data offers only a slice of insight.

Starting late last month, the department posted information for 135 hospitals at www.statehealth.in.gov. Hospitals were the latest in a line of topics covered by the site's consumer reports section. Other areas include hospice care programs and nursing homes.

The site, which the department plans to update every two weeks, covers a lot of ground. Each report contains basic information like the services offered at a hospital and the number of doctors practicing there. It also notes the number of deficiencies found in recent inspections and includes data compiled by the U.S. Centers for Medicare and Medicaid Services.

It's information often requested from the Health Department, said Terry Whitson, assistant commissioner for health care regulatory services.

The Web site "simply is another piece of information consumers can use to help in their health care decision-making," he said.

The federal data show how the hospital per- formed compared with state averages in 10 clinical quality measures. These include basic areas like how often care givers provide aspirin for heart attack patients upon arrival at the hospital.

The federal and state data complement each other, according to Health Department spokeswoman Margaret Joseph.

"For the first time, it gives people the kind of information we want to see available to consumers," she said.

But Hoosiers shouldn't read too much into that information, warns Bob Morr, vice president of the Indiana Hospital and Health Association. He points to the number of deficiencies listed for each hospital as a prime reason.

Every 12 to 15 months, the state conducts an unannounced survey or inspection of every hospital. The reports posted on the Internet show the number of "deficiencies" found during these visits.

They also show the deficiency total found on prior visits and the state averages. However, they don't show the difference between a burned-out light bulb and a broken ventilator.

"On the surface, giving the number of deficiencies and comparing it to the state average doesn't really tell us a great deal in terms of the severity of the issue," Morr said.

The same holds true for the substantiated complaint totals listed for each hospital. The raw numbers don't show the difference between someone who complained about cold food and a patient with a care problem.

"The backup information that would tell me as a consumer, 'Was there really a problem here or not?' at this point in time is not really clear," Morr said.

The lack of useful information is demonstrated by the fact the Web site reports show the state codes cited for a hospital's deficiencies, but they tell nothing about the actual problem.

Whitson said the state doesn't have the technology to put more specific information into the reports, but it might be able to in the future.

"We would just be blowing up systems, I'm afraid," he said. "Right now, we simply do not have the storage capacity to be able to do that."

He noted that the public is welcome to peruse inspection reports if they want more information about a particular hospital.

While the Web site offers limited information, it should provide enough to raise some caution flags, said Dan Chamberlain, a malpractice lawyer with the Indianapolis firm of Doehrman Chamberlain.

If a hospital consistently does not meet basic quality standards, such as giving aspirin to someone suffering a heart attack, it might be an indicator of the overall level of care there, he noted.

Chamberlain said patients should supplement the Health Department's data with a state Department of Insurance Web site, www.Indianapcf.com.

That site, which debuted last year, gives people basic information about whether doctors face pending malpractice claims.

Marion County hospitals showed a range of deficiency totals in their latest inspections. The Rehabilitation Hospital of Indiana and Clarian Health Partners hospitals recorded none.

Now-closed Winona Memorial Hospital registered 13. The state found 11 deficiencies during a May 2003 inspection at Westview Hospital.

That inspection "pointed out some policy and procedure issues that we strengthened a year and a half ago when this report was issued," Westview spokesman George Gill said in an e-mail response to questions about the total.

The health department data is part of a national movement that includes the Medicare and Medicaid information and aims to improve accountability for hospitals, according to Morr. Hospitals support the disclosures, he said, but the data released so far probably raises more questions than it answers.

"This is an early step towards creating better information for you and me as potential consumers of health care," he said.
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