Consumer Reports Rates Surgery; Hospitals Push Back

We, patients, need user-friendly ways to answer this question: Where’s the best place to go for a knee replacement, or cardiac care, or to deliver a baby?

It is virtually impossible to find an answer even though hospitals have reams of information about how often patients recover smoothly and how often they suffer infections, complications or even die after surgery.

A few groups are stepping into the void. The latest issue of Consumer Reports rates hospitals in Massachusetts, and across the country, on surgery. The “overall” scores surprised me.

From Consumer Reports' “Your Safer-Surgery Survival Guide”

From Consumer Reports’ “Your Safer-Surgery Survival Guide”

Carney Hospital at the top is hardly a magnet for patients needing surgery in the Boston area. Some hospitals that are have the lowest overall ratings.

I called Mass General, where the hospital’s senior VP for quality and safety, Dr. Elizabeth Mort, praised the goal of giving patients more information about the quality of care. But she says Consumer Reports’ methods have so many flaws that these ratings “do the patient a disservice.”

The ratings, Mort says, don’t accurately take into account:

– how sick the patient was when he or she came in for surgery or the severity of their disease
– how many other conditions the patient may have
– how many complications actually occurred

The ratings are also misleading, Mort says, because they pool different types of procedures in single category. For example, they pool many prostate procedures, even though some hospitals perform very specialized and difficult surgeries and some hospitals only perform the most basic operations.

Consumer Reports’ ratings are based on two factors: how often patients died in the hospital following surgery and how often they had an extended stay, which is often a sign there were complications. Researchers combed through Medicare billing records. Consumer Reports doesn’t have medical reports that would allow it to adjust for the issues Mort mentioned above.

“That’s a little bit of the point,” says Doris Peter, with Consumer Reports Health Ratings Center, “that clinical data is not widely available to the public and we can’t base our ratings on clinical data if it’s not made available.”

Dr. John Santa, medical director of Consumer Reports Health, says in the magazine that while the ratings aren’t perfect, “we think they’re an important step in giving patients information they need to make an informed choice.” And, he adds, “we hope that by highlighting performance differences, we can motivate hospitals to improve.”

The Massachusetts Hospital Association (MHA) says it supports “greater transparency regarding quality and financial data to better inform the public,” but that “Consumer Reports’(CR) continued efforts to rate US hospitals result in greater confusion rather than clarity with an oversimplification of this extremely complex and important subject.”
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Rankings: MGH Down From Top Spot To No. 2, McLean Leads In Psych

Last year when the annual hospital rankings by U.S. News and World Report came out, Massachusetts General Hospital ranked No. 1 in the nation and threw itself a party, including a celebratory duck boat parade.

Massachusetts General Hospital is one of the highest paid in the state. (Steven Senne/AP)

Massachusetts General Hospital (Steven Senne/AP)

This year, MGH, a Partners HealthCare hospital, was ranked No. 2 in the country, after Johns Hopkins, according to the just-released U.S. News tally:

Baltimore’s Johns Hopkins Hospital reclaimed the No. 1 spot after last year losing a 21-year reign to Boston’s Massachusetts General Hospital.

As far as we know, there will be no parade this summer.

On the upside, McLean Hospital in Belmont, also under the Partners umbrella, was ranked as the overall best hospital for psychiatry. The region’s dominant health system also operates a number of other hospitals that ranked high on the U.S. News list, according to a news release:

Massachusetts General Hospital (MGH) and Brigham and Women’s Hospital (BWH), the founders of Partners HealthCare, rank among the nation’s top ten hospitals on the U.S. News & World Report annual Honor Roll of America’s Best Hospitalsfor the seventh consecutive year. MGH ranked second in the nation and BWH ranked ninth. Continue reading