Thursday, March 3, 2011

Nine Maryland Hospitals Report Higher-Than-Average Complication Rates

On March 2, 2011 the Consumers Union Safe Patient Project posted the following tweet:

If you click on the link, you will find that of the 46 hospitals in Maryland, 9 did indeed have worse complication rates than the others. Another 23 had better-than-average rates of complications. The rest were average with the exception of one which reported no data. The complication rates were based the predicted number of complications [derived from the average number of risk-adjusted complications per hospital in the state] vs. the actual number of complications at each hospital.

At first glance, this seems like a good idea, track the hospitals and post the information for all to see. But wait a second. Whenever you do something like this, there are going to be some hospitals with better, some with average and some with worse rates of complications. The only way this would not be true is if all 46 Maryland hospitals somehow were average, which is highly unlikely. And every hospital cannot be above average. There is only one group that I am aware of that contains nearly all above average people and that is medical students. [See my previous blog on that subject.]

Also, comparing them to the average rate of complications for the state could be misleading. For example, what if Maryland hospitals have a much higher average rate of complications than the average national hospital complication rate? Then the average rate, or even the better-than-average rate, for Maryland might still be an unacceptable rate of complications.

It’s good marketing fodder for the 23 hospitals with better-than-average complication rates. But it will send each of the 9 poor performers into a tizzy. There will be task forces, ad hoc committees, consultants and meetings, meetings, meetings.

Will it result in better patient care? I don’t know. What I do know is that next year there will be some hospitals with better-than-average, some with average and some with worse-than-average complication rates.

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