Writing in ‘The Conversation’ today under the title Hospitals are risky places – but some are better than others, Stephen Duckett & others summarise a new Grattan Institute report ‘All complications should count – Using data to make hospitals safer‘.
The authors note that the rate of complications varies markedly between hospitals. We have data on every complication and every hospital, but the hospitals are de-identified and so they argue:
State governments and private health insurers have this information now. They should share it. They should publish information on complication rates at different hospitals, so that patients – and their referring general practitioners – can know what difference it makes, in terms of complications, going to one hospital compared to another.
This vital comparative complication rate information is generally not even provided to hospitals themselves. Although some states and some private health insurers have feedback programs – where they provide information adjusted for the mix of patients treated in the hospital – such programs are not universal, they are not comprehensive, and the data is often old.
This means hospitals are flying blind when designing safety improvement efforts. They don’t know how they are performing against their peers. They don’t know whether they are the best in class or the worst. They don’t know where they need to improve, or by how much they should improve. They don’t know how they measure up in terms of infection rates among their patients, or falls, or complications arising from procedures.