C’mon admit it: you’re sick of hearing how those goody-goody Canadians provide comprehensive health care to all, while we let an estimated 22,000 Americans die each year (http://www.urban.org/publications/411588.html ) because they don’t have coverage. Or the way their cost of prescription medications is so much lower than ours that Congress finally threw up its hands and legalized the equivalent of small-scale (prescription) drug smuggling. Heck, Canadian provinces even do comparative effectiveness research without anyone calling them Nazis.
Now comes word from the Fraser Institute in Toronto that Canadians are not so goody-goody after all. The institute puts out a peer-reviewed and risk-adjusted report card comparing hospitals in Ontario, the nation’s largest province. Last year, the first for the report, just 43 of 136 acute-care hospitals agreed to participate. This year, though, the number of participants plunged 60 percent, to just 17 hospitals, according to a story in Healthcare IT News.
The report card provides 39 indicators of inpatient quality and patient safety, as well as a Hospital Mortality Index that shows overall performance across nine indicators of mortality. “By refusing to be identified, Ontario hospital administrators are hiding vital information from Ontario taxpayers and patients about the quality of tax-funded healthcare provided in their community,” fumed Nadeem Esmail, director of health system performance studies at the institute and co-author of the report.
Excuse me, Mr. Esmail, but if it’s taxpayer money, why doesn’t your government require hospitals to report? Like we capitalist Americans are starting to do in order to encourage an efficient market? (Oh, yeah — and protect sick people, too.)
Of course, even mandates don’t guarantee the reports will be accurate, as a recent report by the New York City Office of the Comptroller demonstrates. Though New York City hospitals accounted for almost half the patients statewide in 2006, they reported about 39 adverse incidents per 10,000 patient discharges, compared with nearly 70 per 10,000 in the northern suburbs and upstate and nearly 64 per 10,000 on Long Island, according to a story in the New York Times. And talk about variation: one major academic medical center reported 3.6 post-operative infections per 10,000 discharges while a similar hospital had 32 per 10,000. None of these hospitals were named in the report.
Apparently some hospitals believe that “Don’t ask, don’t tell” constitutes a quality improvement strategy.