Friday, March 28, 2008
Hospital shopping
By Caleb Hellerman
Senior Medical Producer

Since you're reading this on your computer, you're probably used to shopping online. Comparing sellers of books, clothes, cameras or music. But what about doctors, or hospitals? For anyone who likes to make informed choices, there are registries of doctors who have faced complaints, and plenty of Web sites asking you to "rate this doctor," but not much useful information. Bit by bit, that's changing.

Here's one example: Today, an organization called the Hospital Quality Alliance (HQA) - essentially the hospital industry, doctors and nurses groups, some insurers and the federal government - are rolling out a revamped version of their site, which displays data from more than 2,500 hospitals, on important measures of quality. You can look at hospitals in your area, or anywhere in the country, and see how often they provide appropriate antibiotics before surgery, how often their heart attack patients survive, and all sorts of other interesting information.

A few months back, my cousin had surgery to fuse discs in his back. If he had checked out this site beforehand, he would have seen that the hospital he chose ranked worst among hospitals in his area in almost every category. As it turned out, the surgery itself was a success but my cousin - usually a stoic type - complained for months about the experience; he said nurses and doctors were rude, ignored him for hours and shortchanged him on pain medication for days after the surgery.

Today, the HQA will make available another big load of information: the results of patient surveys, looking at how well each hospital managed their pain, how well the staff communicated with them and how clean the place was. Web sites like this are popular with anyone who thinks we need more choice and transparency in the health care system. This view is especially popular with conservatives, who say informed consumers making better choices will increase competition, drive down costs and improve the quality of care.

But even a site like Hospital Compare is just a baby step. It measures a fraction of the things that go into high-quality care, and it looks only at hospitals - not individual doctors. Doctors and medical centers have long been wary of being measured by "objective" criteria, because, they say, it's hard to make apples to apples comparisons. For example, a physician who sees patients with more serious conditions might show a lower success rate in treating them.

What information do you want, before choosing a doctor or hospital? And do you feel you really have a choice in where you go for medical care?

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