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ATTEMPT AT HOSPITAL REPORT CARD GEARED TO AUTOWORKERS

Roughly 60,000 people in the Buffalo region will receive a consumer guide to local hospitals in the next week commissioned by some of the biggest employers, Ford and General Motors.

This beginning attempt at a hospital report card is intended to help autoworkers, retirees and their families make better-informed health-care decisions and to prod hospitals to improve quality.

"The lessons are that quality matters, it varies from hospital to hospital, and that quality is important to consumers," said Diane Bechel, director of the hospital-profiling program at Ford.

The information also is available on a Web site for others to see, as are similar reports for hospitals in Cleveland, Atlanta, Indianapolis and southeastern Michigan.

Hospitals here blasted the effort even though many of them received good grades.

"It's a piece of garbage," said William Pike, president of the Western New York Healthcare Association.

Pike pointed to a host of errors, such as describing Erie County Medical Center as a minor teaching hospital and failing to report any births at Children's Hospital. But he reserved most of his criticism for the statistical methods used.

"They compare our hospitals to a national database, but the national database didn't get its information from each state in the same way. How can it have any statistical validity?" he asked.

Pike said hospitals in Buffalo tried to collaborate with the automakers but wanted more time to polish the report's methods in a "trial run" before going public.

"It's not a matter of getting bad grades. We got more good grades than we should have," Pike said. "They needed to meet with us on a regular basis, to get a feel for the uniqueness of health care in this state. They didn't do that."

Bechel acknowledged that the report card is flawed but said it reflects the best information available.

Release of the consumer guide coincides with a new report by the Institute of Medicine that calls for increased attention to patient safety in light of the estimated 44,000 to 98,000 patients who die annually in the United States from medical errors.

Given such statistics, she said, consumers deserve better information about the quality of care at hospitals -- sooner rather than later.

"Our mantra has been, 'Don't let perfection be the enemy of the good.' This is a start, not the be-all and end-all of hospital report cards," she said. "Could the statistical tools be more sensitive to the nuances in each community? Yes. We know we have to improve."

The consumer guide includes a report on patient satisfaction published in October by the Niagara Health Quality Coalition. The findings showed favorable results for childbirth patients, somewhat troubling indications for surgical patients and disturbing grades for general medical patients.

Hospitals collaborated on the patient surveys. The element of the consumer guide that has caused controversy is a section that measures clinical performance, information that for the most part has been unavailable to the public.

The automakers, along with the United Auto Workers and Delphi Automotive Systems, looked at some of the most common sources of hospitalization -- heart and cancer surgery, lower-limb replacement, and respiratory and cardiac care. They graded hospitals on deaths, complications and lengths of stay. The guide also looked at hospital costs and births by Caesarean section.

Among the results:

In deaths for nonsurgical heart care, four hospitals received worse-than-expected ratings: Brooks Memorial, DeGraff Memorial, Lockport Memorial and Mount St. Mary's.

Two hospitals received worse-than-expected rankings for complications from cancer surgery: Kenmore Mercy and Olean General.

Two hospitals received worse-than-expected ratings for complications from lower-joint replacement surgery: Millard Fillmore Suburban and Niagara Falls Memorial.

For Buffalo, the automakers used information from a data system on patients kept by New York State. They were without access to similar data in most of the other cities, so they used statistics from Medicare, the government health program for the elderly.

In Detroit and southeastern Michigan, where the report project began in 1986, the automakers used patient-outcome data voluntarily released by hospitals to prepare the third report card of hospitals there.

The hospital profiles are available on the Internet at www.hiag.org. Click on "Quality Assessment Tools" once at the Web site.

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