Government Ranks Hospital Heart Care Online

June 21, 2007 — -- For the first time, a government agency is telling patients how hospitals stack up when it comes to treating heart attacks and heart failure.

But since its interactive Web site categorizes an overwhelming majority of the hospitals simply as average, the data may leave some consumers begging for further guidance.

After years of hospitals keeping their death rates private, the Centers for Medicare and Medicaid Services, a division of the Health and Human Services Department, today posted online a ranking of more than 4,800 hospitals nationwide.

"This really represents an advance because this puts on the Web actual results that hospitals are getting," said Dr. Harlan Krumholz, professor of medicine at Yale University and a cardiologist at Yale-New Haven Hospital.

Krumholz was involved in developing the formula for calculating the hospital rankings.

The agency will not release specific death rate data for individual hospitals, but after analyzing that data it has grouped the hospitals into tiers -- those with a death rate higher than the national average, those with rates that approximate the national average, and those with lower than average death rates.

The list is posted on the HHS Web site: http://www.hospitalcompare.hhs.gov. To see which hospitals performed above or below the national averages click here.

According to Krumholz, "This is not about embarrassing a hospital or showing worse providers to be bad," but rather it is an cooperative effort to improve health care for everyone.

He said the information will help hospitals see how they compare to each other and find ways to make improvements.

It will also help patients make more informed decisions about hospitals in their community (though Krumholz cautioned that in an emergency situation, a patient should always dial 911 and not be surfing the Web looking for hospital ratings).

A Conservative Start

For now, consumers hoping to find scathing or stellar reviews of their local hospitals may be disappointed.

Of the 4,477 hospitals assessed nationwide in terms of heart attack statistics, 4,453 are grouped in the category marked "No Different Than U.S. National Rate," for which "adjusted mortality is about the same as U.S. rate or difference is uncertain."

Only 17 hospitals rank better than the national average, and only seven rank worse.

For heart failure, 4,734 out of 4,807 hospitals fell into the middle category, with 38 above average and 35 below.

HHS Secretary Mike Leavitt said in a press conference Thursday that while some hospitals may move between categories as more evidence becomes available, the agency opted for a restrained approach in light of misinterpretation problems encountered in the 1980s when similar data was released.

"We wanted to be pretty conservative in terms of our approach," Leavitt said.

Patients May Research Local Hospitals

Still, the information may prove helpful to some. Eugene Cummiskey said he would advise any of his friends to "do their homework" and find out how their local hospitals rank.

Cummiskey said he owes his life to the fact that he lives near one of the best hospitals in the country: Yale-New Haven hospital.

Back in March, Cummiskey went to bed with some pain in his chest. He took a couple of Pepto-Bismol tablets and wrote it off as heartburn.

When he woke in the morning to find the sensation was still there, he called 911. Within minutes, he was being treated by a team of top-notch cardiac experts.

"They acted like a MASH unit without the humor," Cummiskey said. "They had speed and precision. ... They really knew what they were doing."

Today's rankings focus only on death rates for heart ailments, but in the future HHS may release information about deaths from other causes.

Krumholz said they expect to rank hospitals based on data for pneumonia deaths next, possibly within the next year.

But Stephen Shortell, dean of the School of Public Health at University of California-Berkeley, said that for the time being, patients may be better off simply taking their doctors' advice when it comes to interpreting the online rankings.

"The best thing patients can do is to have a good relationship with their personal physician," Shortell said. "Whoever their doctor is, they can help that patient navigate the system and interpret hospital data online."