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Senior Citizen Health & Medicine
Websites Comparing Hospital Performance Show Widely Differing Results
Hospital ranked best on one site was ranked worst on another
 Sept. 18, 2007 – More than 113 million Americans, many of them senior
citizens, went to the Internet last year to seek health information.
Those checking the sites that compare hospital performance, however, may
not have found accurate information. A look at six of these sites found
Medicare and the non-profit Websites are the best for accessibility and
data transparency.
But, the review of publicly available hospital comparison sites suggests
that all seem to display inconsistent results and use inappropriate or
incomplete standards to measure quality, according to a report in the
September issue of
Archives of Surgery, one of the
JAMA/Archives journals.
Of the 113 million Americans who searched for health information on the
Internet in 2006, 29 percent searched for information on specific
hospitals and physicians.
At the same time, pressure from insurance companies and the public for
transparency and accountability in health care continues to increase.
Data on hospital performance is frequently made available through Web
sites aimed at patients, but few researchers have examined these sites
and their content.
Michael J. Leonardi, M.D., and colleagues at the David Geffen School of
Medicine at UCLA, Los Angeles, performed a systematic Internet search in
September 2006 to identify publicly available hospital quality
comparison sites. Six sites were identified and rated on accessibility,
transparency of the data and statistical calculations, appropriateness,
consistency and timeliness.
Of the six sites identified, one was government-run (Hospital Compare
from the Centers for Medicare and Medicaid Services), two were
non-profit (Quality Check from the Joint Commission on Accreditation of
Healthcare Organizations and the Leapfrog Group’s Hospital Quality and
Safety Survey Results), and three were private and proprietary.
"For accessibility and data transparency, the government and non-profit
Web sites were best," the authors write.
"For appropriateness, the proprietary Web sites were best, comparing
multiple surgical procedures using a combination of process, structure
and outcome measures. However, none of these sites explicitly defined
terms such as
complications." All data on the sites were at least one year
old, and most were two or more years old.
To determine consistency, sample searches were conducted on the three
proprietary Web sites comparing four Los Angeles–area hospitals on three
common procedures (laparoscopic gall bladder removal, hernia repair and
colon removal).
The searches demonstrated significant inconsistencies—for example, for
colon removal, one hospital was ranked best by two sites but worst by
the other site, and the hospital ranked best on that site was ranked
worst on another.
"Further work is needed to improve these issues, particularly the
accessibility by patients, the quality and type of data reporting, the
statistical method and the criteria by which hospitals and specific
operations are compared,” the authors conclude.
“It is probably important that surgeons be involved with the development
of such reporting Web sites so that the comparisons accurately and
appropriately reflect the quality of surgical care."
Editor's Note:
This study was supported by the Robert Wood Johnson Clinical Scholars
Program.
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