Inconsistent, dated data leave consumers confused, study finds
TUESDAY, Sept. 18 (HealthDay News) -- Trying to get accurate information on a hospital's quality by looking at Web sites can leave would-be patients frustrated, due to partial or dated data, a new study finds.
In looking over six hospital-comparison Web sites, researchers found they produced inconsistent results and used inappropriate or incomplete standards to measure a center's quality, according to the report in the September issue of the Archives of Surgery.
"Patients are using the Internet to find health-related quality information, and the information is out there," noted lead researcher Dr. Michael J. Leonardi, from the department of surgery at David Geffen School of Medicine, University of California, Los Angeles. "But the information is inconsistent and varies from Web site to Web site," he said.
A lot of Web sites try to rank hospitals, Leonardi said. But because there is no standard way of calculating quality differences, Internet sites come up with different results for the same hospitals, he noted.
In the study, Leonardi's group searched the Internet to find publicly available hospital quality comparison sites. They found six sites and rated them on accessibility, transparency of the data and statistical calculations, appropriateness, consistency and timeliness.
Among the sites they evaluated were the U.S. government's "Hospital Compare," from the Centers for Medicare and Medicaid Services. In addition, they looked at the following nonprofit sites: "Quality Check," from the Joint Commission on Accreditation of Healthcare Organizations and the Leapfrog Group's "Hospital Quality and Safety Survey Results." The other sites were run by private companies.
Leonardi's team compared listed hospitals for three common procedures: laparoscopic gallbladder removal, hernia repair and colon removal.
The searches found significant inconsistencies among the sites. In some cases, the same hospital was rated best and worst for colon removal, depending on the Web site.
The team also found that for accessibility and data transparency, the government and nonprofit sites were the most reliable. However, for appropriateness, the private sites were best, because they compared surgical procedures using a combination of information, including patient outcomes.
However, on all the sites tested, data was at least one year old, and many had two or more years-old data, Leonardi noted.
None of this means that patients shouldn't try and investigate hospital quality, however. "Patients should research where they get their surgery," Leonardi said. "The Internet can be very useful as long as patients use reputable Web sites," he said. "But we need to come up with a standardized approach to collecting and posting data."
One expert believes the Internet can be a good source of information on hospital quality, but patients should not rely on it alone to make decisions.
"Caveat emptor," (let the buyer beware) said Dr. Albert Wu, a professor of health policy and management at Johns Hopkins University School of Public Health, Baltimore. "Disagreements among Web sites suggest that some of them don't have the answer, or none of them have the answer," he said.
A lot of the data that appears on the Internet is being used in ways that it was never intended to be used, Wu added. This creates the possibility of misrepresentation. There's also a lag in the timeliness of the information provided, he said.
Wu believes patients should use the Internet but also get their information the "old-fashioned way," by getting references from other reliable sources. For doctors, Wu believes that there needs to be better criteria established to make sure the data on the Internet is both timely and consistent.
For more on hospital quality, visit the Joint Commission on Accreditation of Healthcare Organizations.
SOURCES: Michael J. Leonardi, M.D., department of surgery, David Geffen School of Medicine, University of California, Los Angeles; Albert Wu, M.D., professor, health policy and management, Johns Hopkins University School of Public Health, Baltimore; September 2007, Archives of Surgery
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