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Determining Medical Quality

March 26, 1993|BARBARA BRONSON GRAY

When it comes to hospitals and health care, it's hard to know what indicates quality. Here's a brief review of the basic things to look for, according to experts in health care and the "Consumers' Guide to Hospitals":

Medicare death rates: Each hospital must submit patient discharge records to the Health Care Financing Administration to qualify for Medicare payments. Deaths reported occurred within 30 days of admission. The data is most useful when compared to other facilities of similar size, and when the trends are assessed over time.

Volume: The number of cases different hospitals handle can be considered an indirect indicator of skill. In some cases, hospitals that perform many procedures seem to be more skilled and successful than those that handle fewer. Hospitals that have higher volumes may also provide more advanced equipment and better support services.

Ownership: Some data suggest that nonprofit hospitals provide better outcomes than do proprietary facilities.

Number of residents: Hospitals with 100 or more residents on staff had the lowest average adjusted death rates for all cases.

Percentage of board-certified physicians: Hospitals with relatively high percentages of board-certified physicians have lower death rates, on average, of Medicare patients. This may be due to better continuing education programs, peer review and consultation available at those facilities.

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