For several years, Medicare Hospital Compare initiative has published quality measures for hospitals. While the Medicare Hospital Compare data is intended to help patients make better decisions, some experts have noted that the public nature of the information might also help spur lower-performing hospitals to shape up, improving the quality of care.
But the project hasn’t led to improvement in 30-day death rates from heart attacks or pneumonia, and is linked to only a small reduction in death from heart failure, according to a new study.
The research, published yesterday in Health Affairs, analyzed Medicare claims data from 2000 to 2008 to come up with mortality trends. And it concludes that with heart attacks and pneumonia, death rates were already improving for other reasons and weren’t improved further by the program.
A modest improvement in the mortality rate for heart failure might be due to the program, but it might be unrelated, the researchers write. More research is needed on that point, they say.
Hospital Compare began in 2005 by publishing so-called process measures for individual hospitals, which look at factors like what percentage of heart-attack patients got aspirin when discharged from the hospital.
“This isn’t a total indictment of public reporting … or of Hospital Compare,” says Andrew Ryan, an author of the study and assistant professor of public health at Weill Cornell Medical College. But the way the program was structured during the time period it was studied doesn’t appear to have significantly reduced the number of patient deaths, at least for these conditions.
In 2008 Hospital Compare began to publish mortality and hospital readmissions rates for heart attack, heart failure and pneumonia, and has also added other measures, such as patient satisfaction, over the years.
“The Hospital Compare program has been evolving, and that could [produce] a change in how patients respond or how providers respond,” says Ryan.
So far the tool has gotten more attention from the hospitals themselves than from patients; this study and others suggest that neither doctors nor patients are paying much attention to Hospital Compare when they pick a hospital.
