What you should know in choosing a hospital (and what Obamacare wouldn’t let you know).
Going to a hospital is taking your life in your hands. New research shows patients treated at the worst hospitals are three times as likely to die as patients with the same health problem treated at the best hospitals. Yet most people pick a hospital based on convenience, a friend’s recommendation, or where their doctor practices.
In fact, your doctor won’t even be treating you. An in-house physician called a “hospitalist” who has never met you will take over. That’s why you need to find out which hospital has a track record of success in treating your problem.
According to the new research, getting the facts on hospital quality is especially important if you have heart problems. Go to the wrong hospital with a heart attack — what doctors call an acute myocardial infarction — and your risk of survival is cut by more than half.
Also beware of huge differences in patient safety. Research also shows that patients have a ten times higher risk of getting a bloodstream infection at certain hospitals.
If you live on New York’s Upper East Side and need bypass surgery or a new heart valve, where do you go? Mount Sinai Hospital is rated 8th in the nation in cardiology and heart surgery, according to U.S. News & World Report. That website rates hospitals all across the nation, and it’s free.
Another web source, Consumers’ Checkbook, (subscription required) also gives Mount Sinai a top rating — five stars — for bypass and valve surgery.
That’s a far cry from nearby Upper East Side hospital, Lenox Hill, which gets only average scores from U.S. News for valve and bypass surgery, and only one star from Consumers’ Checkbook. On the other hand, Lenox Hill gets five stars for gall bladder surgery. It pays to know what type of care you need.
If you’re in Los Angeles and develop heart problems, you’re likely better off at Cedars-Sinai Medical Center, rated 10th in the nation in cardiology by U.S. News, rather than St. Vincent’s Medical Center, which gets below average marks for heart valve and bypass surgery.
What about suburban hospitals? Stamford Hospital and Greenwich Hospital, both in Connecticut, are considered “high performing” by U.S. News for treating heart failure and COPD. Greenwich gets far better ratings for hip replacement surgery than Stamford, but still isn’t tops. Back in the city, look at Hospital for Special Surgery, rated #1 in the nation for orthopedics.
Stamford and Greenwich hospitals earn A ratings from Leapfrog, which grades hospitals on patient safety. As many as 440,000 patients a year die in the U.S. from medical errors, injuries, and infections caused by the hospital. Yikes. Yet New York City’s most prestigious medical centers get only C grades for safety. Hospitals in cities like Boston, Hartford, and Chicago do far better.
Check Leapfrog’s safety grades, too, if you’re having a baby, because safety is important. Rating sites don’t grade hospitals specifically for childbirth. Even if you’re anticipating an uncomplicated birth, make sure the hospital has a NICU — neonatal intensive care unit — for special medical care. Also consider the nurse-to-patient ratio and whether you can get a private room for a good night’s sleep.
Aside from happy moments of childbirth, being hospitalized is generally stressful. Even worse once you discover your doctor is AWOL. About three quarters of hospitals now use hospitalists, doctors paid by hospitals to supervise patient care. The upside is hospitalists are on-site. The downside is they don’t know you from Adam or your medical history, and can’t provide continuity of care once you leave the hospital.
All the more reason to choose your hospital carefully. But unfortunately Obamacare plans don’t allow you that choice. Many of the plans force you into just one hospital in your region. Whatever comes after Obamacare should guarantee patients more hospital choices. Your life could depend on it.
Betsy McCaughey is Chairman of the Committee to Reduce Infection Deaths.
Mt. Sinai Medical Center (Homieg340/Creative Commons)