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Hospital Checkup

Do Your Hospital and Physician Make the Grade?

Reports on Specific Facilities, HMOs, Personnel and the Success Rates of Certain Procedures in the Southland Are Available for the Asking

July 27, 1998|KATHLEEN DOHENY | SPECIAL TO THE TIMES

Performance reports on hospitals and physicians--often referred to as medical report cards--are becoming more common in California and across the nation.

The information can help patients, especially those needing such procedures as heart bypass surgery or Cesarean section, to evaluate a physician or facility before obtaining medical care. The data are also used to help health-care-plan purchasers make decisions and to encourage higher standards among health-care providers.

But awareness of these medical report cards among the public is low, according to a study published in the Journal of the American Medical Assn. in May.

Drs. Eric C. Schneider and Arnold M. Epstein of the Harvard School of Public Health surveyed 474 patients who underwent bypass heart surgery at one of four hospitals listed in the Consumer Guide, a free report of risk-adjusted mortality rates of every Pennsylvania hospital, surgeon and surgical group providing bypass surgery.

Only 12% of those surveyed reported awareness of the report before undergoing the surgery. Less than 1% knew the rating of their surgeon or hospital.

The researchers conclude that some patients rely more on anecdotal reports from friends and family; others are just not aware of the growing availability of these medical report cards or perhaps how to access them.

Finding out exactly where to get the information--available via mail, fax, toll-free telephone lines or Internet--is one barrier. "Patients, even when they get the information, often don't know how to interpret it," says Epstein, chairman of Harvard's department of health policy and management. That's often because data from different sources can be conflicting.

"It would be hard for anyone to interpret," he says. Still, persistence can pay off. "The notion of empowering the consumer is appealing."

Here, a sampling of sources that consumers in Southern California can use to evaluate a hospital or physician:

* The Joint Commission on Accreditation of Healthcare Organizations, which accredits 18,000 hospitals, nursing homes, laboratories and other facilities, began to make public its performance reports in late 1994. Now, the commission will mail consumers copies of performance reports on up to 10 facilities free of charge. To request copies, call (630) 792-5800 weekdays from 6 a.m. to 3 p.m. (Copies can also be faxed, but there is a $15 fee per report, payable by credit card.) The data base currently includes performance reports on 3,675 hospitals, says Julia M. Roberts, a JCAHO spokeswoman. These performance reports are gradually being added to the commission's Web site (http://www.jcaho.org). Go to the "General Public" icon, then click on "Quality Check" and follow the prompts.

"The performance reports are written for the layman," says Roberts. The report details the accreditation decision, the date, the current status of the facility, areas of the facility that have specific recommendations for improvement, how the facility resolved the deficits, an overall evaluation score and scores in specific evaluation areas (such as patient rights, laboratory services and anesthesia care).

* California's Office of Statewide Health Planning and Development, under a legislative mandate, studies and reports on outcomes in California hospitals for specific procedures. Available now are reports on heart attack and lumbar and cervical diskectomy. Under development is a maternity outcomes study.

Consumers can call the Data Users Support Group, (916) 322-2814 weekdays from 8 a.m. to 5 p.m., to order a specific report. Most consumers order Volume 1, containing statistics and a results summary, but some also order Volume 2, the study methodology, and Volume 3, containing statistical tables, says a spokeswoman. The reports are sent free of charge.

The reports can also be retrieved from the Internet at http://www.oshpd.cahwnet.gov.

* The Health Facilities Division of the County of Los Angeles Department of Health Services maintains public records on file for licensed hospitals and other health facilities (excluding facilities operated by the county and the federal government).

These public files include information on licensure, bed capacity, ownership statements, surveys by the state, deficiencies noted and corrective actions taken, among other data. Consumers are welcome to visit the office (5555 Ferguson Drive, Suite 320, Commerce; [213] 869-8500) and read the files without charge, says Jean Olander, program manager. Photocopy fees are 10 cents per page. Viewing hours are weekdays from 8:30 a.m. to noon and 2 p.m. to 4:30 p.m.; calling first is advised.

Topics covered can vary widely. In one file on a community hospital, for instance, one deficiency statement described substandard serving sizes of chop suey; another deficit involved the reuse of anesthesia tubing meant only for single use. The files also include information on whether the problem was resolved.

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