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Brochures Aid Patients in Shopping for Hospitals : Health: Free pamphlets offered by a nonprofit agency give suggestions on choosing facilities. But some consumer groups criticize the publications because they lack hard numbers on success rates for specific procedures.


CHICAGO — How does the smart consumer pick a hospital or a psychiatric facility? What's the best way to find a good doctor? How can you tell which nursing home will suit your needs?

A series of new brochures suggests what questions to ask when shopping for health care. Offered free by a nonprofit agency that sets standards for medical facilities, the five guides nevertheless have been criticized by some consumer groups as practically worthless.

They argue that the brochures fail to provide information that counts: hard numbers on success rates for specific procedures performed by specific hospitals and doctors.

The five pamphlets were prepared and put out by the Joint Commission on Accreditation of Healthcare Organizations, which employs more than 400 health care professionals to survey facilities and determine whether they meet industry standards.

Commissioners represent the American Medical Assn., the American Hospital Assn., the American College of Physicians, the American College of Surgeons, the American Dental Assn. and consumers.

The commission accredits more than 5,400 hospitals, 81% of the nation's total, and 3,600 providers of psychiatric care, outpatient and in-home services and nursing homes.

Accreditation by the commission is required to some degree for hospitals in 43 states. For other facilities, accreditation is mostly voluntary.

Stephen L. Davidow, commission spokesman and author of the brochures, defended them as providing a starting point for health care consumers.

"We're really pleased with them," Davidow said in a recent interview from the organization's office in suburban Oakbrook Terrace. "We wanted to make sure the documents would be useful and easy to use and wouldn't provide too much medical lingo and be confusing."

Each brochure in the "Helping You Choose . . . Quality Health Care" series contains up to 15 yes-or-no questions on the types of facilities the commission inspects and accredits.

The pamphlet on selecting a hospital, for example, suggests considering convenience of location, the cleanliness of rooms and the success rate for the procedure the patient will undergo.

On choosing a nursing home, suggested questions include the facility's philosophy about using mechanical life supports, the size of its staff on nights and weekends, and whether residents can make menu substitutions.

When comparing psychiatric hospitals, a brochure suggests that it's useful to ask when restraints, seclusion and electroshock are used; if there is a procedure for resolving patient and family complaints, and whether clients go home with a plan for continuing care.

Arthur Levin, executive director of the Center for Medical Consumers, a nonprofit education and advocacy group in New York, assailed the brochures as "useless. Not completely useless, but pretty useless."

Hospital patients should be able to obtain procedure-specific success rates, but "you can't get that information from a hospital," and the commission knows that, Levin said.

The burden of asking questions is improperly placed on patients and their families, Levin said, when the commission should be releasing results of its own inspections of health care providers.

Charles B. Inlander, president of the People's Medical Society, agreed.

"This stuff is window-dressing," he said from Allentown, Pa., where the consumer education and advocacy group is located. "These kinds of things don't really tell you about the quality of care."

But Davidow said federal and state laws sharply limit release of inspection results, which are protected by confidentiality rules.

He noted that consumers can, however, find out whether a facility lost accreditation or risks losing it--fewer than 3% do--by calling the commission's customer service line at (708) 916-5800.

The free brochures may be obtained by sending a self-addressed, long envelope with two 29-cent stamps on it to: "Helping You Choose . . . " Brochures, Customer Service Center, Joint Commission, One Renaissance Blvd., Oakbrook Terrace, Ill. 60181.

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