Surgical care at Chattanooga area medical centers gets graded

Surgical care at Chattanooga area medical centers gets graded

August 7th, 2013 by Jeff LaFave in Local Regional News

Dr. Peter Lund, M.D., left, gets prepared for orthopedic surgery Tuesday with the help of Certified Surgical Assistant Arlene Plemons at Parkridge Medical Center.

Photo by Tim Barber/Times Free Press.

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MAKING THE GRADE

<strong>How did Consumer Reports rank area hospitals in 2013?</strong>

• Parkridge Medical Center &#8212;&#8220;Good&#8221;

• Erlanger Medical Care &#8212;&#8220;Poor&#8221;

• Memorial Health Care System &#8212; &#8220;Poor&#8221;

• Hamilton Medical Center (Dalton, Ga.) &#8212; &#8220;Good&#8221;

<strong>How can I research hospitals?</strong>

• Hospital Compare, Department of Health & Human Services (free)

medicare.gov/hospitalcompare

• Leapfrog Group

leapfroghospitalsurvey.org (free)

• Truven Top 100 Hospitals

100tophospitals.com (paid report access)

• Healthgrades

healthgrades.com

• Consumer Reports, September 2013 issue

or consumerreports.org (subscription required)

Consumer Reports, the well-known authority on consumer items like votive candles, lawnmowers and oatmeal, released its first nationwide review of surgical care in America&#8217;s hospitals.

And Chattanooga&#8217;s hospital are urging a second opinion.

None of the Scenic City&#8217;s three major hospitals &#8212; Erlanger, Parkridge and Memorial &#8212; ranked better than &#8220;Good,&#8221; the middle result indicated as a plain white circle halfway between possible &#8220;Better&#8221; and &#8220;Worse&#8221; ratings in the Yonkers, N.Y. publication.

For the September 2013 issue, Consumer Reports analyzed Medicare billing information from 2,463 hospitals to determine how Medicare patients fared during and after procedures such as back surgery, hip replacement, knee replacement, angioplasty and carotid artery surgery.

&#8220;Unfortunately, consumers are just bombarded with information like this,&#8221; said Dr. Mark Anderson of Memorial Health Care System. &#8220;A lot of confusion is really created. We&#8217;re trying to play a football game with too many players out on the field, and the fans definitely don&#8217;t know what&#8217;s going on.&#8221;

<strong> </strong>Erlanger Health System, ranked by U.S. News and World Report as a top regional hospital in 2012, received the lowest-possible &#8220;Poor&#8221; rating from Consumer Reports based on its 2013 criteria.

These ratings are based on billing data, which is not completely indicative of a hospital&#8217;s surgical performance, said Erlanger spokeswoman Pat Charles.

&#8220;This methodology used for gathering data for this report was limited to only Medicare patients who underwent only five types of surgeries,&#8221; she said. &#8220;This limited focus does not accurately reflect a hospital&#8217;s overall surgical record and caseload, particularly a Level One Trauma Center like Erlanger.&#8221;

Surprising results

Many high-performing hospitals with international reputations for surgical outcomes received low ratings in this Consumers Report review, Charles wrote in an email.

World-class hospitals with such unsatisfactory rankings included Johns-Hopkins in Baltimore, Massachusetts General in Boston and the Mayo Clinic in Austin, Texas.

Consumer Reports is only the most recent survey company to dig into health care, but is perhaps the most prolific. Companies like Leapfrog, Healthgrades and Truven Health Analytics all disseminate hospital quality information through a select combination of data.

&#8220;[Research companies] use the national quality forums as their standards,&#8221; said Melissa Roden, Memorial Health Care&#8217;s vice president of quality. &#8220;There are about 45 of them, and Leapfrog only uses a handful of them.&#8221;

The deluge of health care information aftermath can leave patients wondering which service or source to trust most.

Though the idea of surgery reviews seems helpful and earnest for Consumer Reports and its 7.3 million customers, the aftermath can mean real-world consequences for hospitals.

&#8220;It&#8217;s admirable that Consumer Reports is attempting to do this, because we can use [more information] out there,&#8221; Anderson said. &#8220;But for something so complicated as modern health care, I&#8217;m not sure it lends itself to that so well.&#8221;

A large part of the private review industry comes with bragging rights in tow.

Health care facilities are welcome to display U.S. News and World rankings for about $50,000. Consumer Reports rankings may not be included in marketing, but customers are not allowed to access the company&#8217;s findings without an online subscription or magazine purchase.

These price tags in an industry already full of expenses feels unnecessary to facilities like Erlanger.

&#8220;We encourage the public to review official hospital data with the Department of Health and Human Services&#8217; &#8216;Hospital Compare&#8217; site, which we feel is the most accurate and up-to-date,&#8221; Charles wrote.

The Health & Human Services website, which is run through the official U.S. government Medicare program, provides detailed information free of charge. The &#8220;Hospital Compare&#8221; database includes statistics ranging from X-ray safety to Medicare spending compared against national averages, designed to be printed out at home at no cost.

&#8220;Hospital Compare gives you very good risk assessment information about the care we provide to our patients,&#8221; said Jerri Underwood, Parkridge chief nursing executive. &#8220;It is a broad view of how all the hospitals perform. The only issue I have is that an issue very small, one outlier or one complication, can show a giant effect or swing in your results.&#8221;

However, the Consumer Reports advocacy arm known as &#8220;Consumers Union&#8221; claims the field of hospital and health care information lacks consumer resources.

&#8220;Consumers have very little to go on when trying to select a surgery, not knowing which ones do a good job at keeping surgery patients safe and which ones don&#8217;t,&#8221; Liza McGifferent, director of Consumer Union&#8217;s Safe Patient Project wrote in a news release. &#8220;They may as well just throw a scalpel at a dartboard.&#8221;

Despite Human Health and Services programs dating back to 1980, Consumer Reports says its first-year product is the best on the market.

&#8220;We wish we had more access to more comprehensive, standardized information, but this is the best that is available,&#8221; John Santa, medical director of Consumer Reports Health, wrote in a news release. &#8220;And we hope that by highlighting performance differences, we can motivate hospitals to improve.&#8221;

However, area hospitals insist that the doctor is in, and that the doctor knows best.

&#8220;When a patient calls in to find out information about a specific procedure, I give them a list,&#8221; Roden said. &#8220;I don&#8217;t mind to share data with a patient. I always try to give them two-to-three websites they can go to where I know methodology is sound, the data is valid, and it&#8217;s a reputable company that has a track record of more than health care.&#8221;

<em>Contact staff writer Jeff LaFave at jlafave@timesfreepress.com or 423-757-6592.</em>