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Consumer Reports Hospital Ratings Not Akin To Evaluating Toasters and TVs

By Nirav R. Shah, MD, MPH

To make the most informed personal health care decisions, consumers can – and should – consult a number of credible sources available for information related to hospital safety.

In February, Consumer Reports’ Health Ratings Center concluded “New York-area hospitals do poorly in patient safety” based on the Center’s “four key measures of patient safety.”

Unfortunately, this report misses the mark.

Nirav R. Shah, MD, MPH, Commissioner
            New York State Department of Health Nirav R. Shah, MD, MPH, Commissioner New York State Department of Health

First and foremost, Consumer Reports relied on incomplete data and flawed methods to draw its conclusions. Consider the report rated Peninsula Hospital in Far Rockaway as the second "safest hospital” among the nearly 50 hospitals in New York city. This was the publication’s finding despite the reality that Peninsula Hospital closed in April 2012 due to serious, longstanding, and unresolved safety deficiencies uncovered during inspections conducted by the New York State Department of Health (DOH) over the past two years.

Moreover, it is important to note that Consumer Reports rated Harlem Hospital as performing among the worst in the country in the number of Healthcare Associated infections (HAIs), which includes patients infected by catheters and during surgery.

Yet the well-established Hospital Compare website, maintained by the U.S Department of Health and Human Services (HHS), reports Harlem Hospital performs “better than the national average” regarding HAIs. In fact, in 2011, Harlem Hospital received a Leapfrog Award (from a coalition of business leaders in the Northeast) for achieving more advances in improving quality of patient care than any other hospital in the northeastern United States.

Two other institutions rated as poor performers in the Consumer Reports’ ratings - Beth Israel and NewYork-Presbyterian - are also rated as “better than the national average” regarding HAIs on the national HHS website.

While the statistics presented by Consumer Reports are described as “national,” in fact, the data on infections represents less than half of all states. For surgical site infections, only one fifth of states report, and data are up to six years old. New York is among only a handful of states that require both public reporting of performance and perform audits of the accuracy and validity of the data. Without such auditing, hospital infection rates outside of New York - and other state's performances - may be significantly under reported. We know from our own, more recent data that surgical site infections have dropped 15 percent since 2007, and serious central-line associated bloodstream infections have dropped 37 percent in New York ICUs.

Further, only two states other than New York report on colon surgery infections. These types of infections occur at higher rates than for other surgeries, and hospitals in New York would be disadvantaged by doing the right thing: identifying trends, reporting rates, and improving outcomes for patients. By setting up a flawed rating system, Consumer Reports creates disincentives for reporting, and thereby undermines the very improvements in safety they claim to support.

The New York State Department of Health is committed to enhancing patient safety and quality across all health care facilities in the state. The Department urges health care consumers to access a range of well-established and credible information sources when seeking information about patient safety in the state, including:
 

  • Hospital Compare (national, government sponsor)
  • U.S. News & World Report (national, private sponsor)
  • HealthGrades (national, private sponsor)
  • Leapfrog (national, private sponsor)
  • Dartmouth Atlas Reports (national, private sponsor))
  • Hospital Profile (New York, government sponsor)
  • NYS DOH Hospital Infection Reports (New York, government sponsor)
  • Alliance for Quality Health Care (New York, private sponsor)

 

Unquestionably, Consumer Reports has a long history of providing ratings that have provided public value. In the case of hospital safety, however, the publication has strayed from this tradition, undermined its credibility, and done a disservice to the health care field. I suggest they focus on transparency and data availability in their next report, as these tenets form the foundation for meaningful and sustainable improvements in patient safety and quality of care. Clearly, New Yorkers deserve no less.

Re-printed with permission of the New York State Department of Health.
August 2012