For the first time, Consumer Reports will provide patient satisfaction ratings for more than 3,400 hospitals across the United States.
The online ratings, published by the Consumer Reports Health Ratings Center, are based on patient surveys collected by the government's Hospital Consumer Assessments of Healthcare Providers and Systems Survey, known as HCAHPS. The data will be available to consumers in an interface with Consumer Reports ratings.
Subscribers to www.ConsumerReportsHealth.org will be able to access the hospital ratings.
According to Consumer Reports, a team of statisticians and health experts analyzed the government data to develop the ratings. The Health Ratings Center integrated intensity of care rankings, linking patient satisfaction and intensity of care; hospitals that have above-average patient satisfaction ratings provide, on average, a more conservative (and less expensive) type of medical care.
The intensity of care rankings are based on data from the Dartmouth Atlas of Health Care and the Dartmouth Institute for Health Policy and Clinical Practice.
"Intensity of care is a critical part of the equation for consumers because it has many implications – if you land in a hospital that is aggressive, that will mean frequent diagnostic tests and doctor visits, more reliance on specialists instead of primary care doctors, prolonged hospital stays, more days in the ICU and higher out-of-pocket expenditures, without necessarily improving outcomes," said John Santa, MD, director of the Consumer Reports Health Ratings Center.
Santa said Consumer Reports' new ratings demonstrate substantial differences in quality of care across the country, including a link between patient satisfaction and intensity of care.
"Our colleagues at Dartmouth have found that patients who live in regions with more intense care – longer hospitalizations and more doctor visits – rate the quality of care lower, and vice versa," said Santa.
He noted that when Consumer Reports culled a list of U.S. teaching hospitals – specifically, those teaching hospitals that are rated significantly above the national average and those that are significantly below average – a similar pattern emerged.
"Some of the teaching hospitals that got high marks were also among the ones with more conservative care," said Santa.
Some examples of teaching hospitals that rose to the top of CR's Patient Ratings, which also provide more conservative care, are Gunderson Lutheran Medical Center (LaCrosse, Wis.), Mary Hitchcock Memorial Hospital (Lebanon, N.H.), University of Wisconsin Hospitals and Clinics (Madison, Wis.) and the University of North Carolina Hospital (Chapel Hill, N.C.).
Some examples of teaching hospitals that fell to the bottom of CR's Patient Ratings, which also provide more aggressive care, are Mount Sinai Medical Center (Miami Beach, Fla.), Long Island College Hospital (Brooklyn, N.Y.), Caritas Health Care (Elmhurst, N.Y.), Brooklyn Hospital Center at Downtown Campus (Brooklyn, N.Y.) and Bronx-Lebanon Hospital Center (Bronx, N.Y.).
"It's especially important that hospitals responsible for teaching the next generation of physicians encourage an approach emphasizing care strategies that make optimal use of resources while satisfying patients," Santa said.
Subscribers to www.ConsumerReportsHealth.org can look up their local hospital's Overall Patient Experience Rating plus ratings for eight performance measures: doctor communication, nurse communication, room cleanliness, discharge information, attentiveness of hospital staff, communication about new medications, pain control and quietness.
Santa said CR's Ratings point to several areas of concern with U.S. hospitals. "Too many hospitals are falling down on the job in key areas such as communication about new medications, discharge planning and staff attentiveness," he said.
A total of 3,141 hospitals, or 92 percent of all hospitals rated, were given the lowest ratings for staff communication about new medications; 2,794 hospitals, or 82 percent, received the lowest marks for discharge instructions; and, 910, or 27 percent, received low marks for attentiveness of staff.
"The performance of hospitals when it comes to discharge is truly lackluster," said Santa. "While hospitals work to correct this, patients need to be forewarned so they can do everything in their power to get the right hospital staff working with them on their exit strategy, otherwise their chances of ending up right back in the hospital are increased."