Don’t Get Sick in Massachusetts

You’d think that any state that boasts a city like Boston that has as many teaching hospitals and world-class hospitals as Boston would be one of the best cities to get ill in and partake of that excellent medical care.

Well, you’d be wrong.

According to a report the Globe reported on yesterday, the overall death rate for the state’s hospitals was 7 percent higher than the national average.

Ouch. That hurts!

What hurts even more is the lack of transparency of the information that would allow consumers and e-patients to make an informed decision about which hospital to visit in Massachusetts to avoid an untimely death. The report did not identify hospitals by name.

So we don’t know whether you should avoid Mass. General and go to Beth-Israel instead. Or avoid Tufts and go to Brigham and Womens instead. Why should you care? Because:

The analysis by a prominent Cambridge research organization also found wide variation in death rates among Massachusetts hospitals, with patients about half as likely to die at some hospitals than at others.

Wow, I mean, that’s a huge discrepancy. I’d really like to know what hospital I could be twice as likely to die at than another, but the report, the Institute, and the paper aren’t telling me. Nobody is. Well, hospital report cards might tell me, but it’s odd that a report of this nature isn’t providing the singular piece of information ordinary people would like to know. I wonder why?

The institute collects data about patient care from Medicare and hospitals, and uses demographic and health characteristics to adjust the data to allow comparisons among hospitals. It provides the data to hospitals it works with on quality-improvement projects.

Ahhh, that’s why. For hospitals’ eyes only.

Too bad for us.

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Comments

4 Responses to “Don’t Get Sick in Massachusetts”

  1. Susannah Fox says:

    Thanks, John, that is eye-opening data. I know that Boston hospitals are a destination for very sick patients from all over New England and the world. Do you think that has anything to do with higher morbidity?

    I attended a half-day symposium at the National Cancer Institute yesterday in Bethesda where Brad Hesse struck a similar “show me the data” tone: “Most of us manage our wealth care online, why not our health care?” Adam Bosworth (formerly of Google Health) echoed it: “I don’t want a personal health record, I want my data.”

    Bosworth used a stark analogy to make the case for better decision-making tools (which would include all the data that is currently hidden from patients): “As soon as you go into remission, it’s like you are dropped through a trapdoor into a cold ocean. People want help and advice, not PHRs.” (He’s part of a start-up called “Keas” — somehow I doubt it’s another PHR solution :)

  2. John Grohol says:

    I agree. I’m not sure where all these companies are coming from that think consumers want better tools to manage their healthcare data.

    I think consumers want better transparency and better decision-making tools when it comes to their healthcare. Sure, that might include their own data as a part of it, but it’s not something that most people, generally, want to have to worry about on a day-to-day basis (chronic conditions being one of the big exceptions to this rule).

    I think we’re in a very interesting time of the old data hoarding mentality meeting the “show me everything, warts and all” of the “2.0” evolution of the Internet. I actually think that organizations that embrace the transparency mentality sooner rather than later will be the organizations (and hospitals) that people who value such things will flock to.

    Given two hospitals with similar reputations, but one shares with me their mortality rates and medical mistake percentages (and the other doesn’t), I think I’d be more likely to go with the hospital that has less to hide.

  3. Dan Hoch says:

    Returning to Susannah’s point, the big problem with all the efforts to publish data about hospital death rates has been “case mix adjustment”. Doctors and hospital have often justifiably or not claimed “my patients are sicker”, and the truth of the matter is hard to discern.

    With that in mind, perhaps transparency is only part of the issue. For example, law mandates that financial data from publicly traded companies be transparent. However, I don’t think those laws help me personally pick good investments. There is no doubt that society as a whole is better off for that transparency. Others, such as groups of “lay people” in investment clubs (online or face to face), or individuals with specific interest and expertise (investment advisers), can judge and use the data.

  4. Paul Levy says:

    Our hospital, Beth Israel Deaconess Medical Center, posts a slew of outcomes and other quality related data on our website: http://www.bidmc.harvard.edu. Please check it out and submit comments, too, on how it might be more useful.

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