Tuesday, February 23, 2016

Public Understanding of Hospital Acquired Infection Rates

The purpose of publicly reported hospital quality data is to improve patient care and better inform cases. Let's not touch the first objective at this time. Does public reporting better inform patients and allow for better choices with respect to healthcare?

Check out this telling paper published by my friend and  colleague Dr. Dan Morgan. 

The researchers selected 110 randomized, hospitalized patients and assessed their interpretability of hospital acquired infection (HAI) data as presented on the Centers for Medicareand Medicaid Services Hospital Compare website. 

The participants (N=110) correctly identified the better of 2 hospitals when given written descriptions of the HAI measure in 72% of the responses . When no written HAI measure description was provided and hospitals differed by denominator for infection rate, 38% answered correctly (31%-45%). Understanding of HAI data was variable in this cohort. 

Of note, on 5 % of the respondents had ever used the Hospital Compare website and only 36% stated that the Hospital Compare information would help their decision to receive care in their current hospital. This last point is important. It is highly debatable how much choice is truly available to patients. In the USA, many are still uninsured and have no real choice in provider or hospital. Of those with insurance, many must choose an 'in-network' provider or healthcare system. Last, for life threatening emergencies, I doubt that patients are instructing ambulances to take them to their preferred hospital or ER.

Those who feel that medicine is a simple commodity, impacted by Consumer Reports like product assessments, are deluding themselves.