Consumer Hospital Comparison Website Now Includes Quality Data On Readmission Rates

July 9, 2009 | by

Launched in 2002, the Hospital Quality Alliance (HQA) is a national public-private initiative that includes hospitals, physicians, nurses, federal agencies, quality experts, and consumer and business groups. HQA members collaborate to make meaningful, relevant and easy-to-understand information about hospital performance accessible to the public and to inform and encourage efforts to improve quality.

Last year, members of the HQA together with the Centers for Medicare & Medicaid Services and the Department of Health and Human Services created a consumer-oriented hospital comparison website called Hospital Compare. Hospital Compare provides information on how well hospitals care for patients with specific medical conditions or surgical procedures, as well as results from a survey of patients about the quality of care they received during a recent hospital stay.

hospital-quality-alliance

Yesterday, new quality data on hospital readmission rates was made available on the Hospital Compare website. The data includes hospital readmission rates for Medicare patients with heart attack, heart failure and pneumonia. This is especially relevant in today’s healthcare reform environment because the issue of hospital readmissions has been cited by policy makers and the Obama administration as a potential opportunity for improving healthcare quality and reducing unnecessary healthcare spending [2]. Indeed, a recent New England Journal of Medicine study found that almost one-fifth of Medicare beneficiaries discharged from the hospital were readmitted within 30 days; one-third were rehospitalized within 90 days [3].

Until now, hospitals have had only information on those patients who return to their own hospital, but not about patients who were readmitted to a different hospital. Using Medicare billing records from July 2005 to June 2008, the information on Hospital Compare shows how often a Medicare patient with one of these conditions returns to the same hospital or a different hospital within 30 days following their initial stay. Hospitals are placed in one of three categories based on their readmission rate in relation to a national readmission rate – “no different than the U.S. national rate”, “better than the U.S. national rate” or “worse than the U.S. national rate”. Each hospital’s readmission rate for the specific condition also can be compared to its state’s average. Additionally, each rate is shown as a single number, along with a confidence interval that indicates the range of certainty in which the hospital’s true performance falls.

The new quality data on hospital readmission rates is being added to existing information on how often hospitals take the right steps to provide care for their patients, as well as updated information on mortality rates. Available information includes statistics on a variety of quality measures such as:

  • Percent of surgery patients who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection
  • Percent of surgery patients whose doctors ordered treatments to prevent blood clots after certain types of surgeries
  • Percent of heart attack patients given aspirin at arrival
  • Percent of pneumonia patients given the most appropriate initial antibiotic(s)
  • Percent of heart failure patients given discharge instructions
  • Percent of children who received reliever medication while hospitalized for asthma

In addition, Hospital Compare includes statistics on answers to a survey of patients’ hospital experiences, such as:

  • Percent of patients who reported that their doctors “Always” communicated well
  • Percent of patients who reported that staff “Always” explained about medicines before giving it to them.
  • Percent of patients at each hospital who reported that YES, they were given information about what to do during their recovery at home.

You can search for hospital information in your area using either a general search or a specific medical condition or surgical procedure search. The general search provides information on Hospital Process of Care Measures, Hospital Outcome of Care Measures, and Survey of Patients’ Hospital Experiences. The specific medical condition or surgical procedure search provides information on Hospital Process of Care Measures and Hospital Outcome of Care Measures (where applicable), Survey of Patients’ Hospital Experiences, and Medicare Payment and Volume. The Hospital Compare database is updated on a quarterly basis.

Interested in how your hospital stacks up to others in the area? Find and Compare Hospitals

References

  1. Vital New Quality Data on Hospital Readmission Rates Available on Hospital Compare Website. Hospital Quality Alliance press release. 2009 July 9.
  2. Health Reform’s Benefits for Middle Class Under Scrutiny. Kaiser Health News. 2009 Jun 25.
  3. Jencks et al. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009 Apr 2;360(14):1418-28.
    View abstract

Physician Failure to Report Abnormal Test Results to Patients

July 9, 2009 | by
ResearchBlogging.org

A new study published in the journal Archives of Internal Medicine finds that, on average, physicians fail to report clinically significant abnormal test results to patients – or fail to document that they had informed them – in one out of every fourteen cases [1]. In some practices, the failure-to-inform rate is as high as one in five abnormal results.

doctor-on-phone

Researchers at Cornell University’s Weill Cornell Medical College analyzed 5,434 patient records from 23 physician practices across the country, selecting 11 blood tests and 3 screening tests (mammography, Papanicolaou smear and fecal occult blood) commonly performed in the outpatient setting. They consulted with physicians in the appropriate specialties to define a range of clinically significantly abnormal values for each test. For each abnormal result then identified, the scientists searched the patient’s medical record for 13 types of events that occurred in most cases within 90 days suggesting that the patient had been informed. These events included a note stating that the patient had been informed, a repeat of the abnormal test or if a consultation or procedure was performed.

MicroRNAs in Human Health and Disease

July 1, 2009 | by

The central dogma of molecular biology deals with the detailed residue-by-residue transfer of sequential information. It states that such information cannot be transferred from protein to either protein or nucleic acid. The irreversible flow of information is from DNA to RNA to protein; DNA is transcribed into messenger RNA (mRNA) and subsequently translated into protein. However, in recent years it has become clear that additional genetic information exists in the human genome. Non-protein coding RNA (ncRNA) refers to mRNA that is transcribed from DNA but is not translated into protein. These sequences, once thought of as “junk DNA” – portions of the DNA sequence of the genome that don’t have a function – are being found to have crucial roles in human development, physiology and disease. Indeed, recent studies suggest that there are thousands of ncRNAs in the human genome [1-2].

Non-coding RNAs include a class of molecules called microRNAs (miRNAs or miRs). MicroRNAs are highly expressed in normal tissues and are being found to have critical roles in gene regulatory processes during cellular development and differentiation. MicroRNAs are small ncRNAs ~21-nucleotides long that regulate gene expression at the post-transcriptional level. MicroRNAs function by binding target mRNA molecules and either inhibiting translation into protein or targeting them for degradation. Abnormal microRNA expression has been linked to many human diseases, including schizophrenia, autism and cancer.

Tackling Heart Disease Together or Alone: The Behavioural Science of Self-Management

June 24, 2009 | by
ResearchBlogging.org

Heart disease is the leading killer in the U.S. and throughout most of Europe. People’s behaviour can protect and reduce risk of heart disease, and interventions to help people “self-manage” exist. But what is the best way to “self-manage”? A recent study shows that group programmes and self-directed programmes have remarkably different effects [1].

heart-disease

Self-management interventions exist for many health problems. They are notoriously difficult to define. One thorough definition is that it relates to activities undertaken by the person who has a “chronic” or “long-term” condition such as asthma, multiple sclerosis or arthritis. These activities include problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning and self tailoring [2]. Interventions or programmes are designed around these activities to help support people to manage their own illness. The idea is that following attendance at a programme of some sort, the activities and skills learned will be continued to be used, thus improving health, maintaining fitness and/or quality of life and reducing the risk of future acute episodes of ill health. These interventions are popular for many reasons, including the relatively low cost to health service providers as interventions can be delivered by health-care professionals or by people with the relevant condition who have been trained, or a mixture of both. Self-management interventions also allow people with long-term conditions to be meet in a group with people with similar conditions. The experience of being in a group, knowing one is not alone and sharing stories is thought to play some part in the effectiveness of self-management interventions. But to what extent is this true?

Health Highlights – June 18th, 2009

June 18, 2009 | by

Health Highlights is a biweekly summary of particularly interesting articles from credible sources of health and medical information that we follow & read. For a complete list of recommeded sources, see our links page.

Health Highlights