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How to find a good hospital Posted: May 12th, 2010

By Jim Sloan

Jim Sloan is a freelance writer in Reno, Nev.

If you are facing a medical emergency, you must rush to the closest hospital to get help. But if you need nonemergency surgery or must undergo a procedure that has to be performed in a hospital, it pays to take some time to choose the hospital that is best for you. Some hospitals are safer than others, and some hospitals have more experience in certain areas than others, so it's important to do some research.

Fortunately, there is a wealth of information on the Internet to help you compare hospitals. According to the Harvard Medical School Family Health Guide, there has been an explosion of hospital "report cards" in the 10 years since the Institute of Medicine released a report showing that up to 100,000 Americans a year die from preventable medical errors made in hospitals. Some online hospital comparison report cards charge a fee and some are restricted to members of certain health plans, but many are free and open to the public.

What to consider

The U.S. Department of Health and Human Services (HHS), for instance, operates Hospital Compare, a Web site that measures how well hospitals perform when treating certain types of common ailments, such as heart attack, heart failure and pneumonia. The site also gauges how well hospitals provided recommended care for surgical patients.

Hospital Compare allows you to select hospitals in your area and sort the results according to the information you would like to see. It shouldn't be the sole deciding factor in your choice, but it can help you determine what additional questions you should ask.

The service also surveys patients about their experiences at hospitals. According to Dr. Carolyn M. Clancy of the federal Agency for Healthcare Research and Quality (AHRQ), another important measure included in Hospital Care is how often patients treated at a hospital have to return within 30 days of going home.

"These 'readmission rates' are good clues for the hospitals overall care quality," Clancy wrote in November 2009. "Low readmission rates typically mean that good patient care was given during the first hospital stay, and that important information for post-hospital care was communicated effectively."

HHS also recommends discussing hospital choices with your doctor, and asking if a particular hospital is recommended and why. Ask what kind of experiences previous patients have had, and how often the hospital in question performs the surgery or procedure you are getting.

You can also find out what other patients have experienced at your hospital by reviewing ratings compiled by Consumer Reports (CR) magazine. This subscription service includes responses from millions of patients on how well their doctors communicated to them, the attentiveness of hospital staff and other factors. CR also provides Hospital Ratings that measure how well hospitals perform surgeries and prevent infections.

Checklist for finding the right hospital

Along with comparing hospitals with online report cards, the American Hospital Association (AHA) recommends asking the following questions when looking for a hospital:

 

  • Does the hospital offer general or specialized care? Most of the nation's 6,500 hospitals in the U.S. deal with a broad range of conditions, but up to 1,000--mostly in large urban areas--may focus on a special disease or condition.
  • Is it a teaching hospital? If so, you may consider avoiding the hospital in July, when new doctors start. Otherwise, a teaching hospital might be the right choice for you because of its access to specialists and new technology.
  • Has the hospital been successful treating my condition? You might also ask how often the procedure is done at that facility.
  • Is it for-profit or nonprofit? Consumer advocates say for-profit operations are more inclined to curtail treatment for patients--even insured ones--if doing so boosts profits. Some studies have backed this claim up.
  • Is it a government-supported hospital? Often, these facilities are faced with budget restrictions that reduce services and private rooms.
  • What is the nurse-to-patient ratio? According to the AHA, one nurse can care for 3-6 patients (the ratio in the intensive care unit should be one nurse to 1-2 patients).
  • Does the hospital have an ombudsman? Or someone else to handle complaints?
  • Does the hospital look clean? What are the rooms like? Is the dining menu appetizing?
  • Is the hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations? If they are, you'll know the hospital has met certain quality standards.

 

Additional tips for finding a good hospital

In addition to the tips from the AHA, you should consider the following when looking for a good hospital:

 

  • Find out which hospitals are covered by your health insurance plan.
  • Find out as much as you can about the hospital doctor you are going see. Is your surgeon board-certified in the procedure you need? Where did your doctor complete residency training? How many of these procedures has the doctor performed? Studies indicate that a doctor's experience translates into a higher success rate.
  • Learn if the doctor you prefer is authorized to perform procedures at your hospital.
  • How often do patients in the hospital you are considering acquire central-line infections? Central line infections are introduced in the large intravenous catheters that deliver medication, nutrition and fluids to patients and account for 30 percent of all hospital-infection deaths annually. But they are, according to Consumer Reports, "almost completely preventable." Information about infection rates is available through The Leapfrog Group.
  • Find out if the hospital accepts Medicare, even if you aren't on Medicare. If they don't accept it, it could be because the hospital is on probation or has been suspended.

 

Clearly some hospitals are better than others, and the good facilities are happy to share information about their record with prospective patients. Hospitals are also growing accustomed to the scrutiny of potential patients, so don't be bashful about getting answers to your questions.

Hospital-rating websites:

 

  • U.S. News & World Report started ranking hospitals in 1990, and the top 50 hospitals in 17 specialties are listed. The Web site is free.
  • The J.D. Power Distinguished Hospital Program recognizes hospitals with outstanding customer service.
  • The nonprofit Leapfrog Group uses data voluntarily produced so not all hospitals are represented.
  • Consumer Checkbook is from the Center for the Study of Services, a nonprofit who measures "desirability" ratings by physicians and 1996-1999 Medicare data. The service is $19.95.
  • Health Grades rates hospitals by individual procedures. The service is free.
  • The National Voluntary Hospital Reporting Initiative is Medicare's hospital-quality rating system.
  • Select Quality Care is accessible only to people enrolled in certain health plans.