Gainesville hospital officials are baffled by Consumer Reports’ rankings showing them as having poor outcomes for surgery patients on Medicare.
Leaders of the UF Health Shands Hospital and North Florida Regional Medical Center said the rankings used an inaccurate approach and oppose findings by numerous reliable sources that demonstrate that both are among the best hospitals in the country.
Consumer Reports relied on billing information to examine the percentage of hospitals’ surgical patients on Medicare who died in the hospital or stayed longer than expected, claiming that research shows these measures are correlated with complications. It studied results of 27 categories of commonly scheduled surgeries.
The “Who’s Who” of hospitals ranked poorly, notes Ed Jimenez, UF Health Shands Hospital’s senior vice president and chief operating officer. For example, Consumer Reports put Massachusetts General Hospital in the “worse” category on a five-part scale going from “good” to “worse.”
In contrast, the new U.S. News & World Report ranking of best hospitals, released July 16, put Massachusetts General as No. 2 overall.
“It makes little sense that Massachusetts General doesn’t appear among the best in the Consumer Reports rankings,” Jimenez said. “This fact should point out that methodologies are different and yield varied results. Clearly, with reporting on academic medical centers that serve high-acuity patients with the most medically complex conditions, the methodology used by Consumer Reports might not accurately depict the situation.”
Dr. Ann Weber, chief medical officer at NFRMC, also questioned the methodology.
“The length of stay doesn’t take into consideration the quality of care,” Weber said. “Staying longer doesn’t necessarily mean that you have complications. It could just signify that you are a more complicated patient.”
Weber also points to recognition two years in a row by the Joint Commission (TJC) for NFRMC as a key quality performer. Just as Jimenez believes quality recognition by U.S. News & World Report for Massachusetts General calls its poor ratings by Consumer Reports into question, Weber makes a similar point.
“How could a hospital recognized by TJC as one that performs at high levels on quality measures be rated so poorly by Consumer Reports?” said Weber, echoing questions raised by Jimenez about the methodology used.
Consumer Reports claims that it adjusted its data in light of risk factors, including age, gender and health conditions.
Jimenez finds this type of adjustment may not accurately reflect the care at academic medical centers. “The more reliable assessments use risk-adjusted data to reflect the vast differences between the types of hospitals, advanced medical services and patients being assessed,” he said.
The differences in patients among hospitals led some doctors across the country to criticize the Consumer Reports rankings, ABC News reported.
“More complicated patients will tend to be in the hospital longer,” said Dr. Richard Besser, chief health medical editor for ABC News. “Community hospitals, which did better in this report, often refer their more complicated cases elsewhere.”
This pattern skews data for Gainesville hospitals, officials said. NFRMC treats high risk patients referred to it from other hospitals in the region, and Shands at UF treats severely ill patients from across Florida.
The Tallahassee Democrat quoted Cindy Blair, the chief improvement and planning officer of Tallahassee Memorial Healthcare, as saying that the Consumer Reports study “came out of the blue.”
The magazine’s approach is “180-degrees different” from other national and regional risk-assessment comparisons, Blair said, calling its comparison model “somewhat bogus.”
One good way to supplement the publicly reported hospital information, is to seek recommendations of trusted insiders, Jimenez told Business in the Heart of Florida. “If I wanted my car worked on, I’d ask a reputable mechanic for a recommendation,” he said. “If I wanted the best teacher for my child, I’d ask another teacher I trusted for a recommendation. We have outstanding health care resources here and it’s important to stay focused on the big picture and track record of our hospitals’ successes. At UF Health, patients are at the center of what we do, and we commit ourselves to high quality, patient-centered, and safe care.”
Weber said that patients should remain confident in area hospitals. “We live in a community that has good hospitals,” she said. “We’re constantly looking at quality measures in our hospitals and measure ourselves against the standards as set forth by the Joint Commission, which we regard as the true measure of hospital quality.”