Data on how well 4,600 U.S. hospitals perform on common elective surgeries like knee replacements, and on treating chronic health conditions like congestive heart failure were released Wednesday on a new consumer tool from U.S. News and World Report.
The “Common Care” rating system looks at outcomes for five high-volume surgeries and chronic diseases that potentially impact millions of U.S. inpatients patients each year.
“This analysis has broad relevance in terms of addressing the types of patients hospitals see every day,” said Ben Harder, chief of health analysis for U.S News. “We are now on the cusp of being able to provide consumers with concrete, hospital level, very specific information about volumes and performance.”
The new rating is an attempt by U.S. News to broaden its scope beyond just patients with complex and rare diseases. It includes three surgeries: coronary artery bypass grafts and hip and knee replacements. Combined, about 1.4 million inpatients undergo those surgeries each year according to estimates by the Centers for Disease Control and Prevention. It also includes two common chronic conditions: congestive heart failure and chronic obstructive pulmonary disease.
According to the U.S. News analysis, approximately 10% of the hospitals rated in each condition or procedure were high-performing, meaning their quality measures were statistically better than the national average. Another 10% were statistically below average. Thirty-four hospitals earned high performing ratings in all five procedures and conditions.
Though only five treatments were considered in the first iteration, Harder says the group plans to progressively expand. As early as 2016 it may publish data for more than a dozen other elective interventions.
“If you're going to get an elective procedure, you generally have time to do research,” said Harder. “And if you're going to choose, you should have full information about how experienced the hospital is treating that condition and how good their performance measures are.”
U.S. News' latest product comes as safety leaders continue to express concern about the explosion of healthcare ratings and rankings that have proliferated as the nation seeks to lower healthcare costs through greater transparency and boosted quality. Recent studies have found extreme disagreement across the various sites, including instances where top performers on one rating are the bottom performers on another.
To make their determinations about the common procedures, U.S. News evaluated hospitals on more than 25 quality measures, including mortality, readmissions, infections and patient satisfaction, and analyzed more than 5 million patient records. Data was drawn from the Centers for Medicare & Medicaid Services, the American Hospital Association annual survey and the clinical registry of the Society of Thoracic Surgeons.
In a commentary published Tuesday in the Journal of the American Medical Association, Harder and colleague, Avery Comarow, acknowledged the limitations of the science of healthcare quality measurement, a field many regard as still being in its infancy. They note that U.S. News will address those limitations by refining its methods through collaborations with registries and inclusion of outpatient claims data.