Nearly two out of every three hospitals in Utah have higher-than-expected death rates for Medicare patients, according to a report released this week by a federal agency. While that deserves a "closer look" by Medicare officials, it most emphatically does not mean there is something wrong with the quality of patient care in those hospitals.
On the list with higher Medicare death rates are many of the largest, most well-known and highly regarded hospitals in Utah. Clearly, factors other than inadequate care are at work here.The study by the U.S. Health Care Financing Administration, which oversees the Medicare program, figures what the death rates should be based on national averages for the types of patients and illnesses each facility treats.
Obviously, a mere statistical comparison of death rates does not cover many of the factors that go into hospital quality and care of patients - a fact that local hospitals have been quick to point out. In fact, the annual study invariably draws fire and criticism from hospitals nationwide each time it is published.
Even Medicare officials admit that the study does not take all factors into account, such as a hospital treating numbers of severely ill patients. Just a few deaths can skew the percentages.
The chief of the Medicare program says that in past years, one-third of the hospitals with high mortality rates appear to involve "special characteristics of patients that we are not able to adjust for."
What that means in simple language is that patients are different in ways that cannot always be accounted for in a statistical study.
Medicare officials are careful to explain that the numbers are not a clear or necessary indication that medical care at the hospitals is substandard or that the hospitals are performing poorly.
The same message is echoed by Utah hospitals. Their managers say the federal list is not a good guide for the public to evaluate hospital performance or to make decisions about hospital quality.
That is clearly true. Yet, despite the imperfect measurements, the federal list at least provides some information about hospital performance. For too long, the public has had no solid way to judge hospitals and decide which offer the best - or worst - care. Essentially, most patients have been captives of the medical system.
It's not enough for hospitals just to criticize the government report for obvious shortcomings. If hospitals are not satisfied with being measured by imperfect Medicare statistics, they must provide a more meaningful set of standards - some kind of report card that can be understood and used by potential patients in choosing a medical care facility.
Admittedly, this is easier said than done. The hospital industry has wrestled with the question for years, debating how to measure such subjective things as patient satisfaction, recovery rates, and the individual nature of each patient's biology and illness - all issues in quality care.
Then there is the question of who makes the final official judgment and passes out the grades on the report card. So far, nobody has come up with an acceptable answer to that one.
But the search for ways to measure performance must continue. While difficult, some kind of rating system surely is not impossible.