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Consumer Reports study looks at surgery mortality, complication rates

A Consumer Reports study shows that some well-known hospitals may not do better or as well as smaller hospitals when it comes to surgery.

For the first time, Consumer Reports ranked U.S. hospitals based on how patients do during and after surgery. The organization looked at 27 categories for scheduled surgeries and individual ratings for five specific procedure types: back surgery, hip replacement, knee replacement, angioplasty (widening narrows or obstructed arteries) and carotid artery surgery.

The data was based on an analysis of billing claims that hospitals submitted to Medicare from 2009 to 2011. The patients were 65 and older, and 2,463 hospitals were included across the country. The rankings were based on mortality rates after surgery and extended periods of hospital stay because of surgical complications.

"Consumers have very little to go on when trying to select a hospital for surgery, not knowing which ones do a good job at keeping surgery patients safe and which ones don't," says Lisa McGiffert, director of Consumers Union's Safe Patient Project. "They might as well just throw a scalpel at a dartboard."

Doris Peter, associate director of Consumer Reports' Health Rating Center, explained to that they had been working on the project for 18 months. The team had to comb through billing records and identify codes that signified different complications. Part of the problem was that codes vary from hospital to hospital, so the average patient probably couldn't understand them, Peter said.

The report differs from U.S. News and World Report's annual list. The U.S. News and World Report's rankings are based on mortality rates, reputation and process of care (including staffing rates and patient safety).

The categories for the Consumer Reports project were more specific. For example, where Consumer Reports looked at hip or knee replacements, U.S. and World News Report grouped those procedures into the broader category of orthopedics.

The publication made a list of the top 10 hospitals that did at least 10 kinds of surgeries and got a high rating in at least 30 percent of those procedures. They were:

  • Anne Arundel medical Center, Annapolis, Md.
  • Christ Hospital, Cincinnati
  • Enloe Medical Center, Chico, Calif.
  • Greater Baltimore Medical Center, baltimore
  • Memorial Health system, Colorado springs, Colo.
  • Oklahoma Heart Hospital, Oklahoma City
  • Penrose-st. Francis Health Services, Colorado springs, Colo.
  • scripps Green Hospital, La Jolla, Calif.
  • Trinity Rock Island, Rock Island, Ill.
  • Yavapai Regional Medical Center, Prescott, Ariz.

Surprisingly, many renowned hospitals, including Johns Hopkins Bayview Medical Center in in Baltimore and the Mayo Clinic Health System in Austin, Minn. did not place highly.

Teaching hospitals on average did not do any better than other hospitals included in the rankings, and rural hospitals did better than other hospitals.

"I think that hospitals are complex places and it's difficult for hospitals to perform well on everything especially these large hospitals," Peter said.

There were some hospitals in urban areas including Mount Sinai Hospital in New York and University Hospitals Case Medical Center in Cleveland that did well despite the fact that they treated poorer and sicker patients.

Peter pointed out that part of the problem could be that hospitals might not be looking at mortality rates after surgical procedures or prolonged periods of stay.

"It's a pretty broad measure and the hospitals will have to figure out what's causing those extended periods of stay," she said.

The full report can be found in the September 2013 issue of Consumer Reports.

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