Hospital Choice — quality now, cost later

Hospital and road

Denver Colorado is a metropolitan area with several hospitals so the city serves as good example of the dilemma people face to make a choice.

The Denver Metro area is lucky to have good hospitals.  But, the experience one might have as an inpatient depends on many factors including the individual doctors, the nurses and the strength of the quality improvement program at each hospital.  The Center for Medicare and Medicaid Services (CMS) sets quality targets for participating hospitals and measures how  those hospitals perform.  CMS publishes the data and several organizations extract the data and make them available online.  One such site is WhyNotTheBest.org by the Commonwealth Fund.

Hospitals tend to emphasize heart care because it is profitable and it has a strong emotional appeal. However, the average consumer never really knows what will land them in the hospital.  CMS provides  many different hospital quality statistics but the “overall” statistic is actually  the most helpful to consumers.

Quality can be measured by an “outcome” such as mortality.  Or, quality can be measured by adherence to a “process” .  Process measures are popular because they don’t depend on patient factors such as age or poverty.

For example, leaving home in the morning should include the process of putting on shoes and closing the door.  Following that process does not guarantee a good outcome but lessens the possibility of humiliation at work or later finding a burglar in your home.  Hospital process measures reflect the quality of management and the ability of an organization to execute a plan with numerous players.

The following table is CMS data organized by WhyNotTheBest.org.  The “Overall” is a weighted average of all of the process-of-care, or “core” measures.

NAME — Selected Denver Hospitals

Overall

National Ranking

University Of Colorado Hospital Anschutz Inpatient (CO) 99.38% 162 of 1792
Swedish Medical Center (CO) 99.17% 265 of 1792
Presbyterian/st Luke’s Medical Center (CO) 98.76% 460 of 1792
Exempla Lutheran Medical Center (CO) 98.59% 551 of 1792
Exempla Saint Joseph Hospital (CO) 98.33% 698 of 1792
Denver Health Medical Center (CO) 97.56% 1093 of 1792
Centura Health-st Anthony Central Hospital (CO) 95.62% 1619 of 1792


Hospitals love the percentage statistic and hate the national ranking.  There are hospitals in other states that indeed do score 100%.  Just like climbing a Colorado mountain, the last mile is often the hardest.

99.38% or 95.62% means the hospital failed to follow a process 6 or 44 times out of 1000.  One time out of a million would be better.  Which hospital you choose may depend on where your doctor or insurance company sends you.  But, if you have a choice the information from CMS may be helpful.

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