Dr. Howard Marans’ 9 Facts about Hospital Quality

Specializes in Orthopedic Surgery

• Male

• Age 57

Hospital Quality Matters

If you’re like most people facing a health condition that requires hospital care, you’re not thinking about the hospital where you’ll be treated. You’ll go to the closest hospital or where your doctor sends you, and it will be fine. It’s not that simple. Don’t confuse healthcare convenience and quality. Where you’re treated matters—every bit as much as the doctor providing the care does.

1. All Hospitals Are Not the Same

All hospitals are not the same—at least when it comes to the quality of care they provide. Some offer significantly better care than others, and the difference to patients can be dramatic. How dramatic? Your chances of surviving heart bypass surgery could be 85.6% higher at one hospital than at another hospital just down the road. Your chances of sailing through a total knee replacement without complications could be 63.4 % higher. These statistics are based off of data from the Centers for Medicare and Medicaid Services for Medicare-enrolled patients.

2. It’s All About Outcomes

Hospitals are required to report the results of the treatments they provide. This information tells us if patients at a particular hospital are more or less likely to have a successful medical outcome. When it comes to hospital care, success is defined in two ways. Mortality—Did patients die during or after their care? Complication rates—Did patients experience unexpected health issues, such as an infection or blood clot that required additional medical care? Reviewing a hospital’s performance based on objective measures of quality can increase your chances of a good outcome.

3. How We Rate Hospital Quality

Health grades rates hospital quality based solely on objective measures of performance—mortality and complication rates. First, we calculate the mortality and complication rates a hospital is expected to have for a range of common conditions and procedures—from maternity care to knee replacements. Then we calculate the actual (observed) rates at the hospital. After comparing the expected and actual rates, hospitals are placed into one of three categories for their performance on each procedure or condition: better than expected outcomes (5 stars); as expected outcomes (3 stars); and worse than expected outcomes (1 star).

4. What Quality Ratings Mean to You

There are few no-brainers in healthcare—but this is one of them: If you’re treated at a hospital with 5 stars in your condition or procedure, you have a much lower risk of dying or experiencing a complication than at a lower-rated hospital for that condition or procedure. In fact, mortality and complication rates for a given condition or procedure can vary considerably from one hospital to another just a few minutes down the road.

5. How to Ensure You Get the Best Care

First, you need to learn which hospitals in your area perform better than expected (5 stars) for the care you need. To help you do that, Health grades provides objective quality ratings for virtually every hospital in the nation. Health grades hospital quality information is free, publicly available, and easy to understand. Next, you need to find a doctor who can treat you at a hospital with 5 stars for the care you need.

6. Your Doctor Determines Your Hospital

Doctors have admitting privileges—permission to treat patients—at certain hospitals. That’s right. You can’t choose any doctor you want and expect to be treated at any hospital you want. If your doctor’s hospital falls short in quality, you should find a doctor who treats patients at a hospital likely to offer you the best possible outcome. In other words, you may need to limit your search to doctors who can treat you at a hospital with 5 stars for the treatment you need. Healthgrades shows you the doctor’s hospital affiliation(s) so that you can make clear choices.

7. Quality, Not Geography Matters

It’s tempting to choose a hospital right around the corner, particularly if your condition requires frequent hospital visits. In a recent survey, 97% of Americans agree having the right information is the key to making good healthcare decisions, yet 71% admit they are more likely to choose a hospital based on convenience. But if that hospital doesn’t have 5 stars in your treatment or condition, you should look for a hospital that does. While the hospital down the street may be convenient—this does not mean it’s the best choice for high-quality care.

8. Insurance Coverage Is a Practical Matter

When you’re preparing for a hospital stay, your first concern should be getting the best healthcare. But you also need to understand what your medical insurance covers and doesn’t cover. To receive the most insurance benefits and pay the least out-of-pocket for your care, you may need to choose a hospital that participates in your plan. You should still consider hospital quality as you select an in-network hospital. If you’re selecting a plan at work or buying insurance through the new health insurance marketplace, you have a great opportunity to choose a plan that covers services at a hospital with 5 stars in the treatment or condition that applies to you.

9. Informed Decisions Are Essential for Your Best Health

Making an informed decision about your hospital is not difficult and clearly it can make an enormous difference to your health. Focus on hospitals with 5-stars in your treatment or condition—hospitals that show a commitment to high-quality healthcare. Remember, where you’re treated matters every bit as much as the doctor providing the care.