We’ve long advised medical consumers to research hospitals they’re considering using for the kind and frequency of errors they make. But according to a story on USAToday.com, suddenly that’s more difficult than it used to be.
“The federal government this month quietly stopped publicly reporting when hospitals leave foreign objects in patients’ bodies or make a host of other life-threatening mistakes,” the paper reports. That’s contrary to what the Centers for Medicare and Medicaid Services (CMS) is supposed to do, which is making available to the public data on hospital-acquired conditions (HACs).
Last year, according to USA Today, the CMS denied changing its data-reporting practice. But as of this month, the data for eight of these avoidable “conditions” no longer are being supplied.
So where is current information about hospitals with high rates of serious errors, including embolisms (obstruction of a blood vessel by blood clot or air bubble) and transfusions with the wrong blood type?
Hospital Compare is the CMS’ website for consumers to research hospital performance – you determine the nature of the search, either by location or hospital name. The site used to list how often many HACs occurred at thousands of hospitals that accepted patients with severe injuries or illnesses and/or while recovering from surgery. Now, says USA Today, CMS still reports the rate of occurrence for 13 conditions, including infections such as MRSA and sepsis after surgery, but has dropped others.
CMS told the paper that the changes are an effort to make reports “more comprehensive and most relevant to consumers,” and that new measures using data from the Centers for Disease Control and Prevention (CDC) received “strong support” from a partnership of the National Quality Forum (NQF).
That’s a public-private enterprise that reviews performance measures that might be used in federal or private reporting and payment programs. Earlier this year, our blog, “Apparent Conflict of Interest Sullies Panel of Patient Safety Experts,” highlighted problems with a prominent physician in that organization.
Helen Haskell, a member of its Patient Safety Advisory Committee, told USA Today that some members of the hospital working group thought they were voting to strengthen, not drop, the measures.
“When we voted, I certainly didn’t think it would result in the (hospital acquired conditions) being removed from Hospital Compare,” she said. Founder of Mothers Against Medical Error, her son died in 2000 of a reaction to medication after surgery.
According to a spokeswoman for the NQF, it decided to drop the data because it wasn’t “appropriate for comparing one hospital to another.”
Um … isn’t that the definition of “compare”? Contrasting one thing with another of a similar type?
No reporting system is perfect, and the CMS and the American Hospital Association have questioned the reliability of the error data for things like foreign objects left inside the patient after surgery. But we wonder if the disappearance of important data has a political component – the Affordable Care Act (“Obamacare”) requires that the 25% of hospitals with the highest rates of certain HACs, including hip fractures or sepsis (severe blood infection) after surgery, receive less money from Medicare. And Medicare or Medicaid reimbursement also is withheld if treatment is related to one of the eight HACs.
According to USA Today, “CMS said it’s working on new ways of measuring HACs that would represent some of the most common adverse events in hospitals; the HACs that are no longer publicly available are considered rare events that should never happen in hospitals. That makes them both harder to track – and, patient-safety experts say, more important for consumers to know about.”
The fact that they should never happen, but do, is exactly why the public should be able to find out if such events have happened.