Medicare agency releases data on hospital performance

News outlets examine a federal report on the quality of hospital outpatient services and emergency room care.

MedPage Today: "The public can now review data on the quality of outpatient care provided by individual hospitals at the Centers for Medicare and Medicaid Services' Hospital Compare website. The site previously contained only data on inpatient care quality. All the data are derived from records of Medicare patients treated at more than 3,600 hospitals nationwide." The information now available for most acute-care hospitals includes "[r]ates of follow-up imaging studies among women screened with mammography; [p]eriprocedural antibiotic use in patients undergoing outpatient surgery; [a]spirin administration to outpatients presenting with chest pain or heart attacks; [u]se of MRI in patients with lower back pain who had not tried physical therapy or other first-line treatments; [r]ates of 'double' or combination chest or abdominal CT scans. As with the inpatient data, hospitals showed wide variation in these measures" (Gever, 7/7).

The Hill: "Patients searching for a hospital will now be able to compare how much they rely on medical imaging procedures, which can carry dangerous levels of radiation." Information on these procedures "has been added to HealthCare.gov, an online tool that lets users analyze and compare data on patient care from more than 4,700 hospitals across the country" (Pecquet, 7/7).

Richmond Times Dispatch: The new measures give consumers more ways to compare hospital quality. "MRI use for lower back-pain care and the time it takes chest-pain patients to get an electrocardiogram are some of the new categories on the site." The Hospital Compare, which first became available in 2003, "traditionally has focused on inpatient care" (Smith, 7/8).

New York Daily News: Glitches also are evident. For instance, the site includes information about hospitals that have closed but does not include information about VA facilities (McAuliff, 7/7).

The (South Florida) Sun-Sentinel: Based on the data, "[a] small number of hospitals in South Florida and the nation appear to give too many imaging tests, and as a result may needlessly expose patients to radiation, federal officials said Wednesday. New federal figures provided fresh evidence that beneficial tests such as CT scans, X-rays and mammograms are being overused by some doctors in hospitals, raising the risk for patients and wasting health-care dollars" (LaMendola, 7/8). 

The Boston Globe: "Massachusetts hospitals as a whole outperform hospitals across the country on the quality of outpatient care, including providing fast treatment to emergency room patients with chest pain and protecting surgery patients from infections, according to new federal data." Massachusetts hospitals also did better than average on the analysis of whether hospitals use too many MRIs and other such imaging tools, "although some hospitals in the state performed better than others. For example, the agency tracked the percentage of patients with low back pain at a hospital that had an MRI without trying physical therapy or other recommended treatments first. If a number is too high, it may mean a hospital is doing unnecessary imaging tests. In Massachusetts as a whole, 30 percent of patients had an MRI first, compared with nearly 33 percent of patients nationally" (Kowalczyk, 7/8). 

San Antonio Express: "While San Antonio hospitals as a group did fairly well, most had at least one area of concern." For instance, "Baptist Health System, University Hospital and Southwest General Hospital were less likely than the national average to give patients antibiotics within an hour of outpatient surgery to prevent surgical infections. Christus hospitals were less likely to give the correct antibiotic. ... In some areas, San Antonio hospitals did very well compared with their peers. Patients with chest pain got an electrocardiogram 43 minutes after arriving at the average U.S. hospital. In San Antonio, it was within one minute at Baptist hospitals, two minutes at TexSan Heart Hospital, and six minutes at Methodist" (Finley, 7/7).

Hartford Courant: "On average, Connecticut hospitals performed better than the national average in nearly all measures, which include the number of minutes before outpatients with chest pain get an electrocardiogram, the percent of outpatients who receive an antibiotic in the hour before surgery, and how frequently patients receive double CT scans when a single one might suffice. … Hospital officials described the data on the website as a snapshot that patients should consider in context, along with other information" (Becker, 7/8).