Hospital Compare website needs improvement, study says

CMS should focus more on high-risk outcomes than processes, researchers conclude. The federal agency says authors relied on old data.

By Chris Silva — Posted Nov. 4, 2010

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The federal government's Hospital Compare website is not effective in providing patients and payers with accurate information on high-risk surgical procedures, according to a study in the October Archives of Surgery.

The Centers for Medicare & Medicaid Services requires that hospitals publicly report surgical "processes" of care, such as infection prevention and antibiotic administration rates, instead of actual outcomes, University of Michigan researchers reported. The agency requires that two sets of the Surgical Care Improvement Project measures for infection and venous thromboembolism be reported publicly. Hospitals must submit data quarterly, which are posted at the Hospital Compare website (link).

The reporting is believed to aid patients and payers in choosing high-quality hospitals and to stimulate quality improvement among reporting hospitals.

Although the measures were selected because there is strong evidence linking them to certain outcomes, there is reason to be skeptical that mortality rates will improve based on the current reporting mechanism, according to the study (link).

Researchers analyzed Medicare inpatient claims data for six high-risk surgical procedures involving more than 325,000 patients treated at 2,000 hospitals over two years.

"If there is a weak link between process compliance and surgical outcomes, CMS public reporting and pay-for-performance efforts will be unlikely to stimulate important improvements or to help patients find the safest hospitals," the study said. "Currently available information on the Hospital Compare website will not help patients identify hospitals with better outcomes for high-risk surgery."

Researchers concluded that CMS needs to devote greater attention to profiling hospitals based on outcomes to improve public reporting and provide more concise information to consumers.

Medicare officials said in a statement that they felt the time period for data review of the study is too old. The study is based on 2005-06 data, when the public reporting of SCIP was first starting, CMS said.

Officials also disagreed with the researchers findings that the process measures capture "rare and insignificant" phenomena. "Although an observational analysis may not show clear correlation between outcomes and particular processes, it is going a bit too far to conclude that the measured processes are not relevant to improved outcomes," the statement said.

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