Hospital rating site a big hit

The server hosting a newly launched online hospitals rating tool crashed shortly after it was opened to the public for the first time Wednesday, as far more people tried to access it than the statistical agency that developed it had anticipated.

TORONTO — The server hosting a newly launched online hospitals rating tool crashed shortly after it was opened to the public for the first time Wednesday, as far more people tried to access it than the statistical agency that developed it had anticipated.

“It shows that people are interested,” Jeremy Veillard, vice-president for research and analysis for the Canadian Institute for Health Information said in an interview about the resource, found on the agency’s website.

Veillard said CIHI had anticipated 200 people might want to try out the tool, which allows hospital administrators and the public to see how Hospital X stacks up against Hospital Y on 21 health measurements and nine financial comparators.

“As we talk we actually have 3,000 people looking at the website — 3,000 people right now.”

The agency has been collecting these kinds of data for awhile and has made them available to hospitals that are interested in seeing, say, if they are as successful at keeping stroke patients alive as a hospital across town or in other parts of the country.

But the information has not been open to would-be patients.

Now people can see what percentage of the people who undergo a major surgery in a particular hospital die within five days of the surgery and compare it to other institutions.

The same types of figures are also available for patients who died after a heart attack or a stroke.

Other quality gauges include, among others, the percentage of patients who need to be re-admitted for more care after having undergone treatment for a heart attack, stroke or a hip or knee replacement.

Despite the early surge in interest, Veillard said CIHI thinks the major benefit of the tool will be that hospitals will know that the public can see how well they are performing and that will be an incentive to make improvements where improvements are needed.

That’s what happened when CIHI released hospital standardized mortality data a few years ago, he said.

Since those data were released in 2007, most hospitals have made great progress improving their individual results.

“We don’t expect that people are going to change the way that they decide for their care because of this information,” Veillard said.

“There have been lots of studies across the world about releasing publicly information on hospitals. It doesn’t change people’s care consumption behaviour.

“What it does, however, it really forces and helps professionals to focus on key measures and try to learn from variations.”

In reality, most people who need care go to the closest hospital, he said.

For hospitals, they can not only assess their own performance against those of their peer institutions, they can identify hospitals from which they can learn.

If a hospital has great heart attack survival rates, others might want to tap into that expertise, Veillard suggested.

He noted that no single hospital in Canada was better than all others on all 30 measures, nor was there any one hospital that was on the bottom of all the lists. The data in the newly opened site shows that Canadian hospitals saw some improvement in their performances and finances in 2010 in comparison to a few years earlier.

In general, hospitals saw fewer deaths after major surgery, heart attack and stroke and fewer patients were re-admitted after getting care for a heart attack, stroke, and hip or knee surgery. There were also fewer cases of in-hospital hip fracture in 2010 as compared to 2007.

The data show that the performance in Canada’s hospitals is going in the right direction for many key measurements, but there are substantial variations across hospitals.

For example, in 2010-2011 the rate of people who died within five days of major surgery went from a low of 2.2 per 1,000 patients to 16.5 per 1,000 patients, an eight-fold difference.

The report says the rate of in-hospital deaths among patients who have had a stroke within the past month dropped by 15 per cent from 2007-2008 to 2010-2011, but more improvement is needed.

The national average rate was still 15.2 per cent at the end of 2010-2011.

The data reveal these deaths after stroke appear to be higher in eastern provinces when compared to western and central Canada.

Meanwhile, the rate at which patients who had undergone hip replacement were re-admitted to hospital within 90 days of their surgery also fell by 12 per cent over the past four years. Declines were seen in small, medium and large hospitals.

CIHI said study of financial indicators from hospitals show that facilities across Canada have generally reduced their administrative costs as a percentage of total costs since 2007.

Information on individual hospitals and how they stacked up against their peers can be calculated on the CIHI website. The English language tool can be found at:

http://www.cihi.ca/cihi-ext-portal/internet/en/document/health+sy stem+performance/indicators/performance/chrp—ireport—about (EN link)

The French language tool can be found at: http://www.cihi.ca/cihi-ext-portal/internet/fr/document/health+syste m+performance/indicators/performance/chrp—ireport—about (FR link)