Online Tool Allows Consumers to Compare How “Aggressively” Hospitals Treat Patients
by Maggie Van Dyke
An online tool from Consumer Reports puts a positive spin on shorter hospital stays and fewer physician visits—at least during the last two years of life.
The Consumer Reports health rating center doesn’t give consumers data related to typical performance measures, such as mortality or patient satisfaction. Instead, it ranks nearly 3,000 U.S. hospitals according to how “aggressively” or “conservatively” they treat chronically ill patients near the end of life.
Per Consumer Report definitions, aggressive healthcare providers keep chronically ill Medicare patients in ICUs and in hospitals longer during the last two years of life than hospitals that provide conservative care. Aggressive care is also associated with more physician visits, usually with an emphasis on specialty care. In comparison, conservative care includes fewer physician visits overall, with an emphasis on primary care.
An Easy-to-Use Tool
The tool makes it simple to find out how hospitals in the same city or region compare in terms of aggressive and conservative care. After choosing “Illinois” and “Rockford” on a pull-down menu, a list of 10 hospitals in the Rockford area pops up with each hospital’s score from 0 percent to 100 percent highlighted (with 100 percent being most aggressive)
It becomes instantly apparent that only one hospital in the Rockford, Illinois area is rated as aggressive. The rest are rated as conservative.
The web search also reveals how much Medicare patients typically spend on physician visits at the various hospitals in the Rockford area during the last two years of life—ranging from $1,663 at the most conservative hospital to $3,046 at the one aggressive hospital.
Consumer Reports built the online tool with data from the Dartmouth Atlas on Healthcare, 2008, which is based on risk-adjusted Medicare data for patients with life-threatening chronic illnesses.
A Tie to Health Reform
Will the Consumer Reports online tool influence a patients’ choice of healthcare providers? It’s too soon to tell. However, there is interest in the tool. Consumer Reports saw a 25 percent spike in the number of unique visitors to its web site during the week in late May 2008 when the online tool launched, according to spokesperson Tildy La Farge.
Health reform discussions are also shining the spotlight on the “overuse of medicine.” Some experts point to research from The Dartmouth Institute for Health Policy & Clinical Practice that shows wide regional variation in the volume of healthcare services provided to Medicare patients—without any correlating increases in quality measures or patient satisfaction.
“Patients in high-spending regions are hospitalized more frequently, spend more time in the ICU, see physicians more frequently, and get more diagnostic tests than identical patients in lower-spending regions,” write Dartmouth researcher Elliott Fisher, MD, MPH and his colleagues. (Health Care Spending, Quality, and Outcomes. More Isn’t Always Better, The Dartmouth Institute for Health Policy & Clinical Practice, February 27, 2009.)
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Maggie Van Dyke is the editor of the Leadership e-newsletter (mvandyke@hfma.org).