Hospital quality, cost data becoming more available online for consumers, can be difficult to use

Oct 30, 2006--Information on the quality of care provided at individual hospitals is now available online, but "many consumers have a hard time making sense of the information," the Miami Herald reports.

According to the Herald, the "hope is that" improving health care transparency by providing the information on Web sites "will drive business to the providers that deliver the best care at the lowest price, reducing costs and improving outcomes."

However, many observers say that what is now available on Web sites such as hospitalcompare.hhs.gov and floridacomparecare.gov "is often confusing and perhaps useless," the Herald reports. Brian Klepper, head of the Center for Practical Health Reform, said, "It's still a tower of Babel out there. We're getting data. We're not getting information. Information is data made understandable."

Former CMS Administrator Mark McClellan said that he and others want information to be available that makes choosing a health care provider as straightforward as buying a car. McClellan said, "We're a long way from that, but we can't ever get the health system we want unless we can measure it."

The Herald reports that some experts are "skeptical that choosing a health care provider could -- or even should -- be like buying a car." Gerard Anderson, a public health professor at Johns Hopkins University, said, "Each Ford is pretty much the same as another Ford," adding, "In a hospital, each operation, each diagnosis -- it's not the assembly line of care that allows for really good comparison shopping." In addition, some hospital executives say the information posted online can be misleading (Dorschner, Miami Herald, 10/29).

Information Validity Questioned
In related news, the Herald reports that most of the hospital quality-of-care information available to consumers is based on claims forms submitted by hospitals to insurance companies and Medicare.

The federally managed site Hospital Compare currently is the "only major information source" of hospital quality data that is based on clinical data, according to the Herald. The government pays hospitals to collect the data.

Some experts "say it is impossible to do reliable risk adjustments based on billing data," the Herald reports. Marc Volavka, executive director of a Pennsylvania program that publishes clinical data on hospitals, said, "I do not believe that billing data alone is sufficient to do risk-adjusted outcomes to things like mortality or complications."

However, McClellan said that studies have indicated that clinical data and billing data often are similar. McClellan said a study released earlier this year found that risk-adjusted claims data "are good surrogates for estimates from a medical record model" (Goldstein/Dorschner, Miami Herald, 10/29).