|
Hospital ratings shouldn’t be a secret |
|
|
|
Written by Lethbridge Herald
|
|
Tuesday, June 23 2009, 9:12 PM |
Alberta Health Services has done no one any favours by refusing to release the names of individual health facilities whose performance is rated by the think-tank Fraser Institute.
The institute used data from the Canadian Institute for Health Information, derived from patient records provided by hospitals themselves. With information on inpatient hospital stays. death rates and adverse events (such as hospital-acquired infections), the Fraser Institute then adjusted the data for risk, acknowledging that some hospitals treat more high-risk and critical patients than others.
The result is not perfect because statistics alone can’t tell the tale of highly complex institutions, let alone measure them against each other when not all offer the same list of procedures or care.
But the results should be judged for what they are — a useful gauge of overall performance, particularly in terms of patient safety.
In Alberta, for instance, the data pointed to one particular hospital of 102 in the province where newborns were injured at a rate four times the provincial average. At another, patients were more than twice as likely to suffer bed sores. At the top-ranked hospital for 2005-06 and 2006-07, the anonymous hospital experienced a great improvement in its overall score from the previous period. One suspects a significant improvement in quality of care wasn’t a matter of happenstance and this particular facility probably has useful information to share.
But Alberta Health Services decided not to share the names of the facilities because, as President Stephen Duckett told the media, the study information was dated and might cause patients to make unfounded judgments about the health system.
All data that has to be parsed this way is dated and if patients can access information, they can make their own informed judgments.
To “protect” Albertans from their own independent thinking or facilities from harsh judgment or staff at a lower-ranking facility from feeling bad is to miss the whole point of transparency. Knowledge is power. The system is a public one. Let the public see how it performs.
For patients, there’s usually little choice in the matter in the face of a medical crisis. A person in immediate need of care isn’t going to race to his computer to check out how the closest hospital ranked.
But over time, and with access to the information, Albertans can see for themselves how the system is performing, whether there is a crisis in health care as critics of the system say there is, or whether overall, our hospitals are providing quality care, preventing mistakes and treating the sick well. The data paints a better picture overall than judging the entire system over the good experience — or bad — of a single individual in the system at a particular moment in time.
As Nadeem Esmail, Fraser Institute director of health system performance studies and co-author of the Alberta Hospital Report Card, suggests, consumers can find all kinds of information and ratings on everything from cars to vacation destinations.
“But when it comes to the quality and safety of services provided by Alberta hospitals, a cone of silence descends,” he said.
“By failing to allow hospital performances to be objectively measured and reported, the Alberta government is refusing to commit to accountability and transparency, something I’m sure most Albertans will find unacceptable.”
In fact, as a consumer, Esmail and others could go to Alberta Health Services’ own website to find out how restaurants have performed during routine food safety inspections. And they’re not hidden behind some anonymous numbering system, the way Alberta’s hospitals were.
Why should they be? Restaurant patrons can judge for themselves whether any problem found in an inspection is so serious that it warrants not patronizing the business anymore. And knowing the reports are publicly accessible helps motivate astute business operators to run a clean, safety-conscious kitchen, which benefits everyone.
What’s good for the burger joint and the pizza place is good for the health system. Transparency breeds accountability.
|
