Utah health care consumers can become more informed shoppers - thanks to a first-of-its-kind guide released by the Utah Hospital Association.

The new report compares hospital charges for the 36 most frequent illness categories during the first six months of 1988.Association officials say the guide is not an ultimate "bargain hunter" document; it's a start to compare charges of some hospitals.

Twenty-seven of the 44 association member facilities, including general, acute-care and specialty hospitals, voluntarily participated in the study. Of the 27 participants, 19 were Intermountain Health Care facilities.

Among the facilities that did not disclose information were Holy Cross Hospital, Holy Cross Jordan Valley, Pioneer Valley, St. Benedicts, Humana Davis North, Lakeview Hospital, Mountain View and several rural hospitals.

But Gov. Norm Bangerter could force all facilities to release comparative data next year. He said it would be up to consumer groups to determine "if the report is valid.

"If it's not valid, we'll push for a mandate next year," Bangerter said.

The first guide reveals that differences in mean charges were significantly higher at the University of Utah Hospital than other hospitals for some treatments. Utah Valley Regional Medical Center, an IHC facility, also led in high costs in some categories.

But association officials are quick to explain why.

"Each hospital may not provide the same range of services for a particular procedure," said association president Eugene C. Beck. "Since nearly every person is different, procedures may vary according to how sick they were upon arriving and upon the medical techniques used by different physicians."

But the new guide does give a "spectrum" of billed charges for the most common procedures - information that private citizens and public officials have long sought.

Last fall, the Governor's Task Force on Health Care Costs recommended, among other things, that efforts be made to seek more timely and detailed health care cost information.

Similarly, a business coalition - Utah Health Cost Management Foundation - has encouraged hospitals, physicians and others to produce meaningful data upon which employers may help their workers to make wise choices.

While there has been concern that prices do not indicate the quality of care rendered, the comparison of total hospital charges historically has been an acceptable method comparing hospitals.

But Dr. Bruce Murray, association research and planning director, believes that billed charges are losing their value as a comparative tool.

He listed several reasons why.

First, charge data is based on the amount a hospital "charged" the typical patient before negotiated discounts, bad debt and charity care are accounted for. Charges, therefore, indicate approximately what the hospital visits cost patients or what the hospital received in payment.

Second, different factors - such as the age and mission of a hospital, patient case mix, patient payer mix, patient severity of illness, physician practice patterns, quality of care delivered, technology and services, and use of Diagnostic Related Group Reimbursement System - all relate to the final bill.

Murray admits it's very difficult to simply publish a set of prices like you would find at a grocery. It hasn't been done yet. But health care providers recognize the need.

Unfortunately, the information in the new booklet may further frustrate the general public, which generally doesn't have the final say about health care.

Currently, only about 20 percent of the consuming public even has the opportunity to make choices. Most employers negotiate their medical benefits packages through insurance programs, and physicians are still the gatekeepers in determining what care the patient receives - and where.

Copies of the "Guide to 1988 Hospital Charges by Illness Categories" may be obtained from the Utah Hospital Association for $10 each.