JCAHO study questions ‘best’ facility designation

Filed under: Health Care |

U.S. News and World Report’s annual “best” list for cardiac care left out some lesser known – but excellent – hospitals, according to a study from the Joint Commission on Accreditation of Healthcare Organizations.

The study, which compares the news magazine’s results to JCAHO’s research, finds that more hospitals should make the “best” list — and that some hospitals which didn’t make the list actually performed better.

“Performance of Top-Ranked Heart Care Hospitals on Evidence-Based Process Measures,” by Scott C. Williams, Richard G. Koss, David J. Morton and Jerod M. Loeb was published in the American Heart Association journal Circulation last month.

The study is notable because few comparisons of this type have been done, despite the increasing availability of performance measurement data to consumers and health care professionals, JCAHO officials said. Millions of readers turn to the U.S. News & World Report “America’s Best Hospitals” issue when it hits newsstands and the Internet each year, but there are few reference points for validating the magazine’s rankings, Loeb said.

“The U.S. News & World Report ranking of hospitals uses a number of quality-related criteria, and most would agree that those institutions provide high quality care,” Loeb said. “However, the fact that many lesser-known hospitals are also providing excellent cardiovascular care, as demonstrated in this study, is good news for many Americans who may not have access to those highly rated institutions.”

The study compared the performance of 774 hospitals, 41 of which were listed among U.S. News & World Report’s 50 best heart and heart surgery hospitals. The hospitals were compared using 10 measures that are based on clinical treatment guidelines from the American College of Cardiology and the American Heart Association. This includes practices such as giving patients aspirin within 24 hours of arrival at the hospital, prescribing aspirin at discharge and providing smoking cessation counseling.

The commission researchers found that 13 hospitals not included among the magazine’s list of top performers did better in adhering to the treatment guidelines than any of the top 41 identified by U.S. News & World Report. Furthermore, when all 774 hospitals included in the study were ranked based upon their adherence to evidence-based care practices, 313 non-ranked hospitals did as well as the top half of hospitals ranked by the magazine.

“Evaluating hospital quality is a complex task, and until recently, people seeking heart care, for themselves or family members, did not have access to the kind of data used in this study,” Loeb said. “Fortunately, that has changed, for it is now possible for health care professionals and the general public to compare hospitals using measures that relate directly to the quality of care being provided.”

All the hospitals studied were accredited by the commission and submitted data about heart attack and heart failure management practices to the commission. The information is available at www.qualitycheck.org.

Aetna returns to small group market in Colorado

Aetna’s full-scale return to the small business market in Colorado begins this month, with the introduction of several new health option plans.

The national insurance agency gained statewide network access with an acquisition of HMS Healthcare, which led the company to return to Colorado after a five-year absence.

“Aetna is a completely different company today than we were in 2001, when significant financial challenges caused us to bow out of the small-group market in Colorado,” said Bill Berenson, Aetna’s regional head of sales for the north central region.

Berenson said the decision was made despite decreases in the number of people enrolled in small-group coverage in Colorado. The company believes its plans can help the majority of businesses in the state — most of which have fewer than 50 employees.

“This is the largest market in Colorado,” he said. “And we think we have developed plans to help employers who haven’t offered health care before, find the right options.”

More states using health care IT

A majority of states are taking steps to improve the quality, safety and efficiency of health care through information technology, according to a study by eHealth Initiative.

“States Getting Connected,” notes that 38 state legislatures introduced 121 bills in 2005 and 2006 that call for the use of health information technology to improve patient care. More than half the bills were introduced during the first seven months of 2006. The study shows that 36 bills passed in 24 states and were signed into law. Colorado has yet to consider legislation recommending an increase in the use of information technology in health care, according to the report.

In addition, the report shows that 10 executive orders were issued by governors calling for the development of health care information technology initiatives to improve health care in their states.

The study shows that the majority of states introduced legislation to create commissions to study and make recommendations about how technology can improve health care quality and access. Overall, information technology in the health care arena focused on a range of issues: the integration of quality goals, the authorization of grants to support statewide IT initiatives and the state’s support of using electronic means to report information.

The results from the study are available at www.ehealthinitiative.org.

Amy Gillentine covers health care for the Colorado Springs Business Journal.