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How Safe Are NY Hospitals? Health Commissioner Challenges Consumer Reports

Sunday, August 05, 2012

The state’s top health official is tackling one of the country’s best known watchdogs, over hospital safety.

New York Health Commissioner Dr. Nirav Shah, in an editorial circulated by the city’s public hospital system, lashed out against Consumer Reports for its safety ratings that found fault with local institutions.

The non-profit magazine “relied on incomplete data and flawed methods to draw its conclusions,” Shah said. He cited Harlem Hospital, Beth Israel and New York Presbyterian as examples of hospitals deemed by Consumer Reports to have unsafe levels of healthcare-associated infections but considered by the U.S. Department of Health and Human Services to be “better than the national average.”

Consumer Reports has been rating hospital safety for four years. It joins an increasingly crowded field of raters – some commercial, some non-profit, and some government – examining everything from infection rates to health outcomes to patient satisfaction.

The most recent Consumer Reports roundup, in February, included ratings of 1,100 hospitals nationwide, but left out many states entirely, due to insufficient data.

Dr. John Santa, director of the Consumer Reports Health Ratings Center, said New York State’s hospital infection data is more thorough than most other states and the federal government. Santa said the safety ratings for some of the hospitals Shah defended was based on his department’s own numbers.

“There is no perfect system yet, and it’s expensive to validate data,” Santa said. “New York State, to its credit, has taken this more seriously than other states — and the federal government — does.”

Santa praised some New York hospitals, noting that several of those upstate appear to be safer than their counterparts in the five boroughs.

Urban hospitals frequently argue that they have to deal with large populations of low-income patients, with greater health problems than patients in largely suburban areas. Santa challenged that assertion.

 “When you see the data nationally,” he said, “it’s important to ask why a hospital system like Henry Ford in Detroit, which has many of the same challenges as New York City, is doing so much better at infection control.”

Meanwhile, the proliferation of health data and consumer-oriented sources for evaluating and rating care appears to have little impact on patients’ decisions on where to go for surgery or cancer treatment, said Dr. Peter Lindenauer, of Baystate Medical Center, in Massachusetts.

“We still are in the early innings of this game of measuring the quality and safety of hospital care,” said Lindenauer, who has studied how patients use published information.  “If you read Car & Driver magazine, you’ll come to very different conclusions about the car you might want to buy than if you read Consumer Reports, because they put very different weightings on different aspects of the ownership experience.”

Given all the conflicting information, Lindenauer doesn’t blame consumers for largely disregarding hospital safety ratings, whether from Consumer Reports, the government or other sources. But he said the information is improving, and consumers are gradually – and generationally — figuring out ways to use it.

“The same young people who are having more and more of their decisions influenced by ratings on Amazon or reviews on Yelp are likely to put greater emphasis on the kind of ratings that are available about hospitals and physicians,” he said. “I think that’s probably a good thing. To rely on proximity and word of mouth puts patients at a disadvantage.”

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