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Monday, July 21, 2014

Choosing the Right Hospital

Depending on several factors, including your geographic area and your insurance plan, you could have a broad or narrow number of hospitals to choose from. Additionally, you choice of hospital could also hinge upon where your personal physician has hospital privileges.

However, if you ever have to change insurance plans, you might have a choice of plans that don’t include your preferred hospital on their provider lists. There’s a chance you might never use the hospital benefit, but it’s important to make the right choice in case you ever do.

Hospital Ratings

The official hospital site can tell you a lot about the services they offer, the doctors they have on staff, and other things associated with their brand. Unfortunately, these don’t often have patient-centric information. In fact, Becker’s Hospital Review indicates that there are only 10 top hospital websites with patient-centric information.

Ratings by an independent evaluator, like Consumer Reports and The Agency for Healthcare Research and Quality, are the best way to evaluate future hospitals. These companies evaluate patient-centric factors like patient experience and outcomes, hospital practices, their safety score, and heart surgery.

Patient Experience: 

The patient experience rating reports the likelihood that patients would recommend this hospital to others. It is based on a government survey of patients across the country and includes such criteria as pain control, room cleanliness, room quietness, staff helpfulness, and communication with nurses and doctors.

Patient Outcomes:

The patient outcomes rating reports how well hospitals prevent hospital-acquired infections, and how many patients have to be readmitted within 30 days of being discharged, based on data that the hospitals submit to state or federal agencies.

The patient outcomes rating also measures surgical mortality rates – including mortality from post-surgical complications, like deep vein thrombosis – and medical mortality rates, based on Medicare patients admitted for heart failure, heart attack, or pneumonia.

Hospital Practices

The hospital practices rating is based on the number C-sections performed at the hospital and the appropriate use of scanning.

The C-section rates in the US are considered too high and the American College of Obstetrician and Gynecologists have guidelines for preventing unnecessary C-sections. The C-section measurement uses state-based billing data and calculates to calculate the score.

Appropriate use of scanning refers to the number of CT scans performed twice on a patient – once with dye and once without. These double scans have been deemed unnecessary and also potentially dangerous because they expose patients to extra radiation. The appropriate use of scanning measurement uses billing data submitted to CMS to calculate the score.

Safety

The safety rating refers to multiple categories regarding patient and hospital safety many of which overlap with the previously listed ratings. The criteria for the safety rating include: hospital acquired infections, mortality, patient-medical staff communications, readmission rates, and appropriate use of scanning. Some rating systems may pull this information from the patient outcome and hospital practices scores, or they may have a separate data collection system.

Heart Surgery

The heart surgery rating is based on coronary bypass procedures and aortic valve replacements. Both categories measure patient survival rates, and the rate of post-surgical complications. The coronary bypass category also rates used the best surgical technique, which improves long-term survival, and it rates whether or not patients received the correct medications before and after surgery.

Some rating services might require you to have a subscription to access hospital rating information. However, some insurance companies can also provide hospital ratings to both current and potential customers.

This is a blog post by Nancy Evans.

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