Higher risk of deaths at public hospitals compared to private: Report

By Dr. Ananya Mandal, MDMay 18 2010

In a new and most extensive national survey conducted in Australia, it has been found that patients in public hospitals are more likely to die there than their counterparts in private hospitals.

The Productivity Commission conducted the survey and found that even after taking into consideration the baseline condition of all patients, those in private hospitals died 12 percent less than those in public hospitals. They studied deaths at 459 unidentified public and private hospitals collected over three years to 2007.

However the report also found that very large public and private hospitals that handled 10,000 to 20,000 cases a year had similar death rates. Considering the expected mortality rates of the nation, the commission found that public hospitals had rates 6.6 percent more than national rates where as private hospitals of the same size had 18.2 percent less than the expected rates.

In very small hospitals that took in around 2,000 cases per year the rates were even more discouraging for public hospitals. Public hospitals had 40 percent higher mortality than private hospitals. “Management performance” and service to remote areas is cited as factors that could have shown such results. The reports show that the most effective hospitals were those with lowest mortality rates and good management.

The study has given “hospital standardized mortality ratios” that take into consideration various factors like patient characteristics, including age and the number of patients with multiple illnesses, which increase in-hospital mortality, and other factors that reduce death risk, including younger patients and a narrower range of services. Costs factors could not be analyzed due to inadequate information.

According to Nick Xenophon, the independent senator who prompted the study, the report shows “…an appalling lack of data on Australian hospitals which could hinder healthcare reform”.