Patients as consumers


Published: Thursday, January 2, 2003 at 6:01 a.m.
Last Modified: Tuesday, December 31, 2002 at 5:34 p.m.

Hospital patients were once just that -- patients. In the new age of health providers, they have become consumers.

Making a decision about what hospital to use hasn't been easy for these new consumers. The American hospital industry has resisted rankings and ratings. And even if a hospital was accredited, it turns out that the Joint Commission on Accreditation of Healthcare Organizations wasn't doing the policing job that it should.

The commission is under a directive of Congress to see that hospitals run safely. But last month, the Chicago Tribune found that Palm Beach Gardens Medical Center in

Florida had kept its high rating even though inspectors from the Centers for Medicare and Medicaid Services had found infection-control deficiencies -- uncorrected since

a previous inspection -- placed patients in "immediate jeopardy."

The commission on accreditation announces its inspections three months in advance, giving hospitals plenty of time to follow correct procedures more closely -or even to

hire more nurses temporarily to improve the ratings.

The Tribune reported that the accreditation process is being overhauled, but changes won't take effect until 2004.

But early next summer, a new system will be in place to allow consumers to better judge a hospital's performance. The report cards will be based on three common,

serious conditions: heart attacks, heart failure and pneumonia. Each of those areas have 10 measures of medical treatment.

"This is a very, very important step forward," said Carolyn Clancy, acting director of the federal Agency for Health Research and Quality. "This system ensures that the

information will be used not only to inform consumers, but also to improve quality."

The process is voluntary, but hospitals might want to consider the consequences of holding back. "We intend to make it known who is participating with this process and

who is not," said Dr. Dennis O'Leary, president of the joint commission on accreditation. He said the 10 measures were "a very modest beginning, but the system of public reporting they represent is hugely important."

Reporting can not only help consumers, but it can lead to a hospital's improvement as well. In 1990, the Winthrop-University Hospital in Mineola, N.Y., had one of New

York's highest death rates for heart-bypass surgery patients. Once that became known, doctors and other professionals sought the causes and solutions. In two years, the death rate had dropped from 9 to 2 percent; by 1998, Winthrop had the best record in the state.

Consumers, as well as hospital administrators, will benefit from the new shopping list.

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