Talk Story
It’s easier to pick out
a fridge than a hospitalAS consumers, we are inundated with information about restaurants, movies, films, books, golf clubs, CDs, cars, appliances, tools, sound systems, computers -- stuff that makes our lives more enjoyable, but isn't vital.
Critics and reviewers take competing products apart, stack them up against each other, run them through torture tests and measure their every quirk, idiosyncrasy, advantage, feature and failing.
By contrast, when it comes to staying healthy or surviving an illness, we base decisions on reputation and word of mouth. Unfortunately, people who might have critical information to share -- for example, which hospitals or doctors to avoid -- don't always survive.
Even if they did, how could someone compare, say, one hospital's hip-replacement success rate against another's? A coronary bypass isn't like a new car -- even if it costs about as much. Nobody goes back in two or three years just to try the latest model.
Today, however, just as you can go to eopinions.com for advice on everything from airlines to Xbox games, you can go to the Internet and compare how local hospitals stack up.
www.healthgrades.com offers report cards for hospitals, including those in Hawaii. You just select your state and region, agree to a lengthy and intimidating user agreement and pick a medical procedure. Up pop the ratings.
HEALTHGRADES uses a star system: five stars for exceeding standards, three for meeting them and one for substandard performance. Since it was at the top, I chose cardiac bypass.
Straub tops the local cardiac bypass list, which ranks hospitals that perform these procedures according to the percentage of patients who survive. Straub had a five-star rating in 2000 and has stayed in a three-star tie with Kuakini and Queens ever since.
Studies show practice makes perfect. Hospitals handling hundreds of cases usually develop expertise that improves outcomes. Accordingly, healthgrades.com lists how many cases a hospital handles each year. It rated Kaiser, with only 77 cases, separately and gave it three stars for 2002 and 2001, a step up from one star in 2000.
Relative rankings change. For treating stroke, Straub has a five-star rating in 2002. Queens and St. Francis had five-star ratings in 2001 and St. Francis, Kuakini and St. Francis all had five-star ratings in 2000.
Other types of cases are ranked by their relevant criteria. For example, hip-replacement surgeries are ranked by incidence of major complications, such cardiac arrest, excessive bleeding, serious infections or strokes.
ANOTHER 'NET resource is healthcarechoices.org, which has a link to the American Board of Medical Specialties Web site. After you register, you can log in and see whether your doctor is board certified.
In Hawaii, it can help to know your doctor's first and middle names -- a search for Dr. Ho turned up five and there are two Dr. Mark Lums, for example.
According to ABMS, specialty boards certify that doctors "have received appropriate preparation in approved residency training programs in accordance with established educational standards." Certification requires doctors to pass comprehensive exams and meet rigorous requirements.
Using the American Medical Association's "Doctor Finder" at ama-assn.org, you can find a doctor or check one out. It lists medical school, year of graduation, where the doctor served residency after graduation, his or her primary practice area and certifications.
ONLINE REPORT cards are better than nothing, but they are sketchy. Naturally, hospitals with substandard ratings aren't happy about them and have lots of cogent arguments disparaging such rankings.
The Wall Street Journal reports that Madison, Wis., is in an uproar. The Alliance, an employer consortium, published a detailed, color-coded report at qualitycounts.org showing which of 24 area hospitals had fewer mistakes, complications and deaths for surgical and nonsurgical hospital stays.
The nonprofit, private Hawaii Health Information Corporation gathers this kind of hospital-by-hospital information in Hawaii. HHIC compiles huge quantities of data and spews it back at hhic.org. However, sensitive, hospital-specific information isn't shared with the public.
No, don't expect to find data on hospital errors, patient complications, mortality, malpractice or anything else that would actually help you select a hospital or physician.
Trust us. Your health is too important not to -- right?
John Flanagan is the Star-Bulletin's contributing editor.
He can be reached at: jflanagan@starbulletin.com.