Government website lists rates of surgical complications, infections and other problems
Article Source: msnbc.com
from:msnbc.comHow safe is your hospital? New website lets you check
Seeded on Mon Oct 17, 2011 9:40 AM EDT (msnbc.com)
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This is great news, as long as you need a straight-forward, routine procedure.
Now, let's look at the unforeseen consequences. Let's say that you are a patient with multiple medical comorbidities (i.e. diabetes, coronary artery disease, obesity). Let's also say that you need a complicated surgical procedure. In other words, you are a high risk patient with a good chance of experiencing a medical and/or surgical complication. So I ask you - who is going to want to do your surgery? Soon, because of reimbursement being tied to outcome, hospitals will begin refusing to allow these risky procedures to be performed at their institutions. Likewise, physicians will begin "cherry-picking" their cases, and refusing to perform the risky procedures out of fear of being maligned by the government. So what will that leave you? A long wait to see a surgical subspecialist at a tertiary care center that is located hours away from you. And don't forget - you will have to drive all the way back to the tertiary care center for your follow-up, because local physicians tied to community hospitals will not treat you out of fear of being implicated in your complications.
This is why we should have considered the ramifications of the government getting involved in health care before our "representatives" passed all of these measures. In other words, we should have read it before we passed it "to see what's in it," instead of vice versa.
Of course, I'm sure I will be told that I am wrong. After all, I am only a surgical subspecialist in a high-risk field who has been getting heat from two community hospitals about how complications will affect hospital reimbursement. Enjoy your drive, because you fools who support unread bills will ultimately get what you deserve.
You sound just like the kind of person I want operating on me.
Well said Joe.
I have to agree that this is a very ill conceived approach to improving hospital care. Some hospitals either because of their reputation or their location tend to handle far more riskier cases than other hospitals. These riskier cases have much higher probability of complications. If hospital start getting penalized every time there is a complication, then hospitals will start shying away from these riskier cases. This will make it harder for someone who has multiple medical problems to get treatment. This program needs to be seriously rethought before it is put into action and starts affecting how hospitals determine which patients to accept and which ones to turn away.
Totally agree. With the looming shortages of primary care physicians, hospitals will see an influx of patients through the emergency room. Since HC reform, there have been numerous reports of PC drs opting for retirement rather then going along with the reimbursement rates that are set by the government. If a surgeon has to choose between a medicare/medicaid patient and a privately insured patient to operate on at the same time, I wonder which one they would choose.
@AlMightyDollar....funny you should say that. Because, if you 'shop' around for a surgeon with a good rating, that is the type you are likely to find...one that does less risky procedures so the outcomes will look good.
Once again doomsayers complaining before all the facts are in. The article said they would be judged on a variety of metrics. I would think cherry picking patients would be one of the metrics. If not, I am sure it can be added. Point being that we need health care reform and have to start somewhere. I am glad we did not wait for the do nothings to make a move. Don't like the law, start working to improve it and leave the propaganda out of it.
We are not talking about cherry picking and the term you have used, is not a metric and wont be added. What Joe and others have said are the realities of health care in the US and the hospitals/physicians/nurses and other HCP that take care patients with multiple co-morbidities are the ones who get the bad cherries from the tree.
Well AW, what do you feel needs to be changed. Have you notified your Congressman. Of course accountability always worries anyone subjected to it.
"hospitals with the lowest quality—as judged by a variety of metrics, not just the new patient safety measures"
joe -- A "variety of metrics!" This change is a good beginning compared to what we have now, which is NO information. It's telling that you pick a most complicated procedure when hospitals perform hundreds of different surgical procedures every day exposing them to all types of errors. This process may not be perfect, but it is a start. I as a potential patient will use it.
All the physicians in our small town "sleep together" so to speak. If one of them makes a mess of you - too bad - the others will not open their mouth even given a straight up mistake by one of their "bedfellows".
joe, that's the first and I bet best post of the thread. Everyone can just stop reading there because he says it perfectly. There's really nothing else to say
One big and very important factor that is never mentioned in these reports. How are these issues measured? There are no good consistent ways of measuring a lot of these issues. The way you do this is to set what you are measuring, give specific criteria to report and then see where everyone is at.
This is not the way it is currently done and because of that, you need to be cautious with this data. Infection rates are one of those right now that does not have any standard that is accepted as to what you are actually getting when you look at the govt. data.
Maybe not wrong, but certainly on the hospitals side. Hospital worker?
I think this is a great idea as long as there is a way to weight the results to allow for the fact that some hospitals are going to perform riskier surgeries and procedures. And I think that, whatever the results may show, people in the Detroit area know that U of M, for example is going to be a place to go for very complicated stuff. Also, I think that infections are infections, and the rate that these occur should definitely be publicized. You should have seen the number of times I had to bring up hand washing when my wife was hospitalized this summer for a bad infection, and the stethoscope that was supposed to stay in her room soon vanished. If you don't want to have to drive all over creation to find a safe hospital, having the government force compliance through penalties is, unfortunately, the only way to go. Last, I wish I had had something like this to hold over the hospital employees head when she told me they we out of blankets on a night I was shaking uncontrollably after surgery.
<<Last, I wish I had had something like this to hold over the hospital employees head when she told me they we out of blankets on a night I was shaking uncontrollably after surgery>>
Now that this is available go ahead and "hold it over the hospital employees head" it won't make a blanket appear out of thin air and it certainly won't improve the remainder of your stay. By the way, uncontrollable shaking after surgery is not cured by a blanket. It is an unfortunate side effect of anesthesia. But you go on thinking that blanket would have made a difference.
Capn jim. Actually, infections are not infections. What is the hospital measuring? What constitutes a reportable infection? How do they know if the patient did not have something going on prior to hospitalization? What about people who come in from other facilities such as a nursing home or after having surgery at another hospital and end up at another for more care?
I was shaking so bad that I hit the top of the bed. I asked several times for blankets, but they finally brought me a cover not more then a heavy sheet.
Frustrated - Should a hospital be out of blankets? The point is she was too lazy to check with another floor. When I finally got a warmed up sheet, it did help.
Catch - I think we can figure out a way to factor in all these other considerations. Are you saying not to bother with hand washing or other sanitary procedures? Can't we look at a hospital who's results are way out of line and figure out the cause. Over 100,000 people die each year from hospitial borne illness - something has to be done.
It might be safe in the hospital, but in many areas of California and other states you risk robbery, car jacking or all kinds of nasty things when you park your car and try to walk into the hospital. Some hospitals are located in a war zone.
It's not even safe IN the hospital (not in CA). My father had a heart attack and died in the waiting room of a hospital as medical staff worked on him. When they gave me his personal belongings a couple of hours after it happened there was no money in his wallet and his watch was gone. My father was old school and never left the house without at least $200 on him and his watch was from his retirement after 40 years at the same company. The staff at the hospital picked him clean as was dying. Miserable scumbags.
Such everyday hazards is another reason why everyone needs SOME sort of access to affordable healthcare. What if somehow everyone chose a career path they LOVED instead of based on steady pay/job security.
Interactions between customers and employees would reach new heights in courtesy and service.
A brother-in-law was in an accident that crushed his leg. He was taken to a famous hospital in L.A. Ca. The family went there and found that his wallet was gone, as was his watch.
Some of these are pretty close to stupid, not to mention unavoidable in some cases. For instance: A wound that splits open after surgery on the abdomen or pelvis. Not uncommon at all in patients who are morbidly obese and diabetic, which conditions go together pretty often. And deaths after admission for heart attack, congestive heart failure, or stroke? Come on, now. This might just indicate that the hospital has a more elderly patient base. Everyone dies, eventually, and these are 3 of the biggies in the elderly.
A lot of this was pushed by JCAHO, the people who make it nearly impossible for us to do our job. They masquerade as "safety overseers" but they are really only interested in maintaining their existence.
The website would be great if it was available!
Dear Maurice:
You're right. I tried it too and there was a screen that popped up that said Diagnostic Error. I guess they don't want you to know.
Ditto here....couldn't get anything.
I wonder why?
Maybe overloaded from everybody checking it out because of this article. ???? Just sayin'.
I couldn't get it, either.
No info available on VA hospitals.
I think that this is BS. I've asked for an investigation of my surgeries in Nebraska and at Mayo Clinic for the last 10 years to no avail. I've written to almost all major newspapers and news media still to no avail. 200,000 innocent Americans are dying every year due to preventable medical error (a commercial airliner full of people going down every day of the year) and can anyone remember the last arrest by the FBI or the DOJ? How many of the dead are coincidentally uninsured, or poor? Shouldn't the FBI and DOJ have statistics? How about me sitting down in an MSNBC forum with Robert Mueller of the FBI and Eric Holder of the DOJ, and I'll show them what I have and they can speak as to why I have been ingored by their Departments? These guys are political panderers.
your 200,000 figure sounds inflated
I'd like to see the source
The web site doesn't work. Another wasted government operation!
Probably crashing from heavy traffic.
Obviously. All the moronic paranoid comments about "govt sites" from baggers, when it's obvious due to MSNBC promotion of the website, it's getting tons of hits.
"Another wasted government operation" - IDIOT!
This trusted site has the basic scores until our gov workers come back tomorrow. There is little to no chance any gov employee will reboot servers until after 9:30am coffee break tomorrow.
http://www.consumerreports.org/health/doctors-hospitals/hospital-ratings.htm
LemansOwner,
You're probably right! That's what his $60,000+/yr. salary is all about!
LemansOwner - many thanks, your site worked!
Site works fine for me. Maybe you need a real connection instead of piggybacking on your neighbors wireless signal.
Not to mention it, even if I could access that website to evaluate my hospital, (nothing comes up when I try to access that website) how is anyone going to make choices in an emergency why most people go to hospitals anyway? This is not the time to pick and choose your hospital. People usually go to the hospital in their area. The ambulance takes you to the hospital in your area.
Site is accessible. Try again.
http://www.hospitalcompare.hhs.gov/staticpages/learn/importance_quality.aspx?measurecd=AHRQ
-HHS Technical Support
It's disgusting how unclean these hospitals are! Dirty bathrooms are the least of it. Yet, hospitals continue to cut housekeeping staff! The latest research shows that copper kills germs and recommends ALL metal surfaces, especially in patients' rooms be copper, NOT stainless or chrome, or whatever. AND that research also shows that THOROUGH cleaning DOES kill germs, but that hospitals, with too few cleaning staff, are more concerned with how many rooms are "cleaned" rather than being concerned with how clean the rooms are!
The research also shows that hospitals who have implemented the recommended practices have cut their infection rate by up to 80%!!! AND, money was saved because they had fewer long-term expensive stays that result from the hospital acquired infections!
NO hospital is safe. The greedy doctors, pharmaceutical companies, insurance companies, and the hospitals themselves are out to bankrupt you. And Obamacare does NOTHING to control the ever rising costs of these needed and required services. It does however FORCE you to buy insurance whether you want it or not.
Well, no one says by law you need to go to the hospital. Yes, affordable health care is a dinosaur but at that revealing ER moment when your ribs are split apart while the heart massage is going on, rants like yours kinda fall silent, yanno?
And after they save your life, chances are you'll thank your lifesaver.
Rather than thinking of "penalties" you should think of any fees or lack of as incentives to GET INSURANCE you know the SMART thing to do. Renters insurance = smart, auto insurance = smart, health insurance = get it now?
As for controlling costs. Do some reasearch on "Spreading the risk" mkay? K thx.
It isn't that you aren't happy to have your life saved, NEVER said that. Nor would you NOT thank the care givers but BOTH of you MISSED the point and obviously have NOT paid attention to the problem. Her are just two examples of the greed.
1) My doctor charges $150 for an office visit but the insurance has a "deal" with him and ONLY allows a $75 charge which he accepts. Well, if you are WILLING to accept $75 then why not charge EVERYONE the same rate instead over-charging.
2) My daughter recently had a procedure done. Her portion of the bill with her insurance was $2300. When she called the doctor that did the procedure and told them she worked for a urologist they deducted 25% off the bill making her portion about $1700. This then shows that the bill is inflated by at least 25% or they wouldn't be able to reduce the cost. And it also means they are gouging people since the original bill was NOT the "real" cost of the procedure.
We regulate the phone industry, electric industry, and a few others and leave medical care alone to run rampant. The BIG three, doctors, pharmaceuticals, and insurance, are ALL greedy and in this together whether you want to believe it or not. Get it yet? OKAY? K THANKS!!!
I wasnt disputing the fact that the health industry is a racket. I was responding to the last line of your initial post where you blame Obama for not controlling costs.
Health care costs incl. the fact that doctors order CAT/MRI scans ONLY to cover their arse unnecessarily costing patients $300-600, etc are no doubt the problem.
I am 35 yrs old. NEVER had a cavity, never had a broken bone (only lacerations), rarely get sick. RARELY see a doctor. If healthy people like myself bought health insurance then costs would go down for everyone.
That is what HCR is based on. More healthy people in. Ratio of claims per total covered individuals is reduced. Costs go down. For the record I would support single payer but as Obama realized, such a change is TOO drastic especially in the eyes of TORIES (conservatives).
The foreign influence in our medical system calls to direct attention the DEATH by ERRORS. Language must be specific...and it is not. Our nation allows Open Borders Invaders--then the same (ex) Catholic CHurch has to imports Latinos for their illegals and on and on it goes with each group. So all the medical professional we have cannot take care of the influx of over 7 million annually onto USA soil--all while US Troops as US Citizens of Generations lives are systematically sacrificed on foreign soil.
A perfect example of inability to know English. An Asian female discharged a family member; but failed to include all of the medications required. She died months later after surviving Open Heart Surgery...
She had 4l nurses and only two were American with their primary language being English...she feared for her life.
Discharge had SEVEN Stepford Females all clothed in grey suits; tight form fitting; short skirts: were supposed to be doing the JOB...that is what transpired.
My mother died in hospice care 11 days after leaving hospital with MERSA, that she Did Not have entering the hospital. The best place to kill yourself is ::::: Go To A Hospital.
Dear Jo Navarro:
My own mother acquired hepatitis in a hospital once.
Add our name to the list of MERSA/family member lost in a hospital.
Miss you, Brother :(
Part of the problem with MRSA being so widespread is that patients demand antibiotics everytime they get the sniffles and unfortunately many of my colleagues are so gutless that they won't tell them no. The bacteria unfortunately become resistant to antibiotics very rapidly, and with Obamacare (hopefully not) being implemented there will be less money available for research to develop new antibiotics.
My mother almost died because the doctor forgot to read her chart and performed a surgical procedure on her while she was on coumadin. She even asked them if she needed to be weaned down on her dose before the procedure. They didn't listen. They didn't read.
They sure gave her the red carpet treatment after she came thisclose to meeting her maker! All of a sudden, they are sending nursing staff to her home to tend to her round the clock.
I can testify to the horrible medical care we have. After working in the medical center in Houston, Texas for 12 years, I saw the side of doctors most patients are not privileged to see. It was not a pretty sight. If you don't participate in your own medical care they will, far too often, kill you. Part of this is due to neglect, and also in large part due to stupidity. Physicians know very litttle about the new drugs that come out every month - about all they know is what the "drug rep" tells them - you know the pretty young lady, with high heels, and all spiffed up? They do not take time to research the medications. A good pharmacist can be your very best friend - but for such a person, I would not be alive today. He caught two drugs that were not to be taken at the same time - I owe him my life and gratitude. To be fair, physicians have very little pharmacy in their schooling - wouldn't do too much good in view of the huge number of new drugs every day. I do not disagree with any of the comments above either - it is partly the patients fault for always wanting a "pill" to solve an imagined problem. Folks "enjoy poor health" so to say.
sassy,
that is just the biggest load of baloney I've ever read.
Do you honestly think that the majority of dr's pharmacology education is from drug reps??? So medical school, residency and fellowship are just for fun. Riiight...
Pharmacists do catch drug interactions. thats their job. Its the reason the system is the way it is. That doesn't mean that dr's don't know anything; it means they are human, can't know EVERYTHING, and make mistakes occasionally. Just like you
@eric, im sure such education becomes out of date and like Information Technology, very rapidly at that. Regarding Drug reps being cute with high heels I can attest to that haha.
A woman i know is a rep for Bayer. So sweet. Blond. Naturally curly. Ended up marrying a doctor surprise surprise. She doesnt have an unethical bone in her body however as for other reps I can only imagine what goes on behind the scenes.
I worked in the hospital system for years-for a lot of people they were shocked at what really goes on when they became patients, an eye opener you might say. Least you may forget hospitals exist for the sole purpose of making money; that goes for the so called non-profit hospitals too. Just remember Hospitals are a business, some are controlled by corporations, and they are always looking at the bottom line. Good idea is to know your doctor, know about your hospital from past patients and if you know any nursing staffs that are reliable ask them, especially if surgery is on your schedule. One last thing don't mention the names of those who are giving you the information as they will be sitting on the Hot seat. Is it as bad as this article relates—for most it can be very trying and confusing and yes there are many continuing uncorrected mishaps as a norm.
sure, education becomes out of date
That is why doctors are required to complete a certain number of CME's (continuing medical education) hours yearly
Most hospitals will also fund educational trips to national conventions, especially if you are presenting
And most doctors have a subscription or access to journals that keep them up to date
The real safety issue is this. The statistics show that the United States ranks 35th or so on the scale of healthy Americans and health care. We are like a banana republic. The countries that don't have this rating are the ones that have socialized medicine. If you can't afford care in the United States, you usually don't get it. If you do get it, it is because it's reached such emergency proportions and you are allowed to go to the hospital if you have no insurance but the bills come later. The doctors will also give you but limited care if you are uninsured after you leave the hospital. This is the reason we rank at the bottom of the list on our health and health care.
Who pray tell is going to pay for the care, it is like any other government program the demand will icrease geometrically. Have you checked on the tax rates in the European socialistic states? They are sky high, also that is why gasoline is very expensive in Europe because they use the taxes to support the medical beaurocracy
The U.S. ranks very low in healthcare OUTCOMES, not procedures. We're also the fattest country. Diabetes delays healing, slows blood flow, and provides a great environment for bacterial growth. Hospitals charge a lot, but if we took care of ourselves, we would be less likely to be there in the first place.
Dear GulfVet49 & Justbecause:
You two have got gripes but no solutions.
My solution is to get the government out of the business of medical care, you have to admit that everytime the government gets involved things go down the tubes, for example AMTRAK, the mortgage industry (remember Fannie Mae and Freddy Mac), I could cite other examples but you probably get the drift......... Bureaucrats have no business trying to run something they have no experience with or knowlege about.
Red Wolf do you have any solution???
Probably nothing more than the tired old liberal talking points.
Gulfvet
Couldna said it better. Americans look in the mirror after their 5th heart attack, and see an out of shape, obese, diabetic person who hasn't exercised since the carter administration and thinks "this must be someone elses fault!"
I would appear this post has overwhelmed the servers ?
Its working now try again
http://www.hospitalcompare.hhs.gov/staticpages/learn/importance_quality.aspx?measurecd=AHRQ
-HHS Technical Support
I wish they had a way to cross-reference the performance of all hospitals and doctor's offices. It would make it SO much easier to find a doctor that isn't an unsanitary, out-dated quack.
I had surgery for a aorta anuerism in 1997 and nearly died. I got an infection and my lungs quit on me. Was on a ventilator for 2 weeks and was sedated so i did not know anything. Was in the hospital for 5 weeks and came home on oxygen. I walked a little every day and went a little farther every day so now i am off of oxygen. My doctor told me that he did not think that i was going to make it. There is a lot better way of fixing an abdominal anuerism now. Instead of cutting you wide open they can go up your groin and fix it.
does it take into account the nurse to patient ratio ??? remember she is the one that will catch problems not the dr that sees you max 15 min per day.
Boycott Black Friday
Boycott Black Friday
Boycott black Friday, spread the word
If you believe anything this Administration puts out you are very sieve...Not once have they published the TRUTH about anything....
You honestly believe EVERYONE currently serving the PUBLIC the best way they can are Obama lapdogs GTFO out of here. Another random statement that reeks of prejudice and closed-mindedness. Give it a rest.
Having worked in 3 different countries healthcare systems in the past 33 yrs I am able to have a broad view of the good and bad in healthcare. A lot of acquired hospital problems e.g bed sores, resp problem, infections are due to a lack of nurses, horrendous housekeeping, lack of hand washing, fragmented care and unnecessary medical or surgical interventions. There are very good doctors and hospitals out there but a lot of the time there is failure to "do the right thing" due to pressure to"generate revenue", because "insurance will pay for it", pressure from pts and families to 'do something", or medicare/medicaid will pay for it. I think it is a good thing that doctors will think twice about intervening with a pt. The fact the USA costs more per person per year for healthcare than in Europe and other civilised countries that have better pt outcomes at a third of the cost and longer lifespans says a whole lot !
I agree with a large part of that post
I would argue that the fear of liability adds a lot too...something our european counterparts don't have to deal with
The outcomes say more about the comorbidities associated with your average american pt. (e.g. diabetes, obesity) than the quality of healthcare in america.
Eric, I do know that in Europe people do sue and win cases but you don't get the big payouts like you do in the USA. In the UK if you bring a lawsuit against anyone or a healthcare instituition if you lose you not only have to pay your legal costs but the legal costs of the defendant. This prevents a a lot of frivilous lawsuits. Errors occur anywhere there are people. In Europe you are allowed to be human and "make a mistake" particularly if in difficult circumstances (on duty for 36 hrs etc). In the US there is no allowance for being human.
I totally agree with you
I personally think it could be a good thing exposing these quack doctors,nurses and hospitals and hold them accountable for there incompetance
I went to the emergency room in may for a broken rib.when i got my statement from medicare it showed that they had given me one pill that cost 138.00 dollars. Medicare refused to pay for it and the hospital sent me a statement for it. I read up on it and it was for an upset stomach from taking chemotherapy. I did not pay for it and the hospital took it off my bill. Just imagine some of the things that hospitals put on your bill that you do not know about.
President Odumbo required that all medical information be put online. So now your information is available to any hacker who wants to know. It is like Obama's Blackberry. Heck, China probably listens or views everything to Obama's Blackberry. Ignorance is bliss. Obama is bliss. Obama is ignorance. The news media elected a complete Chicago Democrat: ignorant, incompetent, corrupt!
You are totally wrong about your medcial info. being available online. If you post a thought or opinion at least get the facts coirrect before you do so.
Tom have you not heard of EMR electronic medical records which are mandated to be in force by 2014. Uncle Sugar is bribing us physicians to use EMR by 2013 we will receive a pittance as a bonusuntil 2014 and if we are not doing his bidding we will be subjected to a cut in reimbursement. The catch phrase is "meaningful use" but none of the bureaucrats can define it. The law of unintended consequences will kick in soon. The idea is that physicians world wide will be able to get your medical records if they are treating you in a location away from home. But not to worry the info is "password protected" you know like the Pentagon computers. I firmly believe that soon all medical records will be available not only to medical personnel but to any hacker that wants a look.
So what do you suggest gulf vet? Color coded manila folders? The private sector is feverishly working on Data Loss Prevention products to help those who choose to go PAPERLESS.
http://www.google.com/#hl=en&q=data+loss+prevention
Standard Insurance is paperless. Are you as worried about hackers getting information about your 401k?
http://www3.standard.com
adidas
I am still a big fan of dictated/transcribed medical records. Our hospital practice has eClinical which is not a user friendly system. The system frequently goes down and if you want to retrieve a record you are screwed! The interchange of information is still easily done, a consent to release records is signed by the patient, it is faxed to the appropriate record holder, and then presto the information is faxed back to the requesting physician. Nothing in the HIPA law prevents sending the records from one physician to another in an emergency situation.
As far as someone hacking into my 401K so what, it's practically worthless thanks to government interference!
LOL. I cant tell if you are anti-obama or just anti-govt which would include being anti-bush/GOP. Without govt interferance (TARP) your 401k would BE WORTHLESS not practically. Fortunately the second part of TARP was released with SOME conditions unlike when Paulson/Bush was in charge.
Question regarding that same statement. On the flip side of your "so what about my 401k" .... then what are the problems with patient data being compromised?
What info is contained in medical records besides SSN and a mailing address? Is payment info (credit cards) bundled with medical chart notes?
The medical record might possibly contain information about HIV status or other disease states which could be embarrassing if released to the general public, it's kind of like the information between you and your lawyer or you and your priest. In other words it is private information that you wouldn't want discussed publicly.
Hypocritical. How is this any different than No Child Left Behind, Bush's program that "rewarded" higher achieving schools with more funding. So many argued that this would only hurt the poorer schools and teachers argued that they didn't want to be "graded".
Is it not reasonable to suggest that hospitals that serve poorer neighborhoods would not rate as high and therefore would not receive additional funding?
You are absolutely right!