For the first time, consumers can pore over abundant data -- much of it previously unpublished -- about Illinois hospitals and surgery centers on a state-sponsored Web site that launches Thursday.
The 2008 data include information about what these medical providers charge, how many procedures they perform, how often they deliver recommended care, and how consumers rate their care.
People scanning the site will learn that the median list price for a colonoscopy can run as high as $36,400 at a Chicago surgery center, and that having a bunion surgically removed can cost $21,616, before any adjustments.
They can also find which hospitals use registered nurses most often -- and which turn most often to nursing assistants, which holds down costs. They can check which hospitals deliver the most babies in Chicagoland and which perform the most cesarean sections.
The long-awaited publication of Illinois' first Hospital Report Card and Consumer Guide fulfills the promise of legislation passed in 2003. The goal was to help people become better consumers of medical services and hold medical providers accountable for their performance.
Industry groups and advocates welcomed release of the data, which was delayed for years as the Illinois Department of Public Health struggled with funding shortfalls and legal and regulatory logjams.
"We're very pleased to see this information come out and become available to consumers," said Patricia Merryweather, senior vice president of the Illinois Hospital Association. (To access the site after 9 a.m. Thursday, go to www.idph.state.il.us or www.healthcarereportcard.illinois.gov.)
"It did take longer than we had hoped, but the timing fits in perfectly with the national health reform debate," said Rep. Julie Hamos, a key sponsor of the original legislation along with Barack Obama, then a state senator. "By putting sunshine on the health care system, it will help improve quality and lower costs."
The state will add a lot of information to the Web site over the next year, making it far more robust, said Mary Driscoll, division chief of patient safety and quality at the Illinois Department of Public Health. For instance, hospital-acquired infections for each institution aren't in the initial report but eventually will be, Driscoll said.
"It's an important first step -- the kind of information we haven't had before," said Larry Boress, president of the Midwest Business Group on Health.
Nineteen states, from New York to Texas to California, have similar state efforts to track the quality of hospital care and report data publicly. Experience shows that hospital leaders and insurance companies pay close attention.
"Once this kind of information is available, hospitals work hard to try to make things better, and that's very valuable," said Dr. Carol Wilhoit, quality improvement medical director for Blue Cross and Blue Shield of Illinois. "We, too, will be very interested in looking at the data."
The American Federation of State, County and Municipal Employees, Council 31, along with Citizen Action/Illinois, Women Employed and Champaign County Health Care Consumers, are creating a new Illinois group, the Campaign for Safe Patient Care, to "raise awareness about the new Web site and educate consumers," said Jo Patton, director of special projects at the AFSCME council.
People will need help making sense of the information and understanding its applications as well as its limits, Patton said.
Some of the data appear relatively clear on the surface; some are more complicated and will raise more questions than they answer. "As with all data of this kind, ask questions" of your doctor or your local hospital if you need a better understanding, Merryweather of the hospital association advised.
For example, take the site's information about charges. These are the sticker prices for medical services, which people with insurance do not pay. Instead, insurance companies negotiate discounts and members pay part of that discounted amount.
(A new law in Illinois requires hospitals to also extend discounts to people without insurance who earn up to 600 percent of the federal poverty level in Chicago. The law does not apply to ambulatory surgery centers.)
The variations reported in charges are striking. The median list price for a bunionectomy (the surgical removal of a bunion) is $21,616 at The Oak Brook Surgical Centre but just $3,516 at the Hinsdale Surgical Center. Hospitals show similar ranges: The charge for an uncomplicated vaginal birth is $16,134.97 at the University of Chicago Medical Center, compared with $6,614.04 at Hinsdale Hospital.
Officials from the Illinois Department of Public Health say all the data was provided to medical centers in advance and that they had the chance to check it for accuracy.
Some of the information comes from Medicare Compare, published by the federal government, but it is presented on the state Web site in a much more accessible form. A consumer can search 51 hospitals within 25 miles of the Tribune Tower in downtown Chicago, for instance, and find out which hospitals adhere most often or least often to recommended standards of care for patients with heart attacks. (St. Mary and Elizabeth Medical Center, Claremont Campus, wins the best score.)
Because heart attacks can strike without warning and patients are taken to the closest hospital by ambulance, it may also be useful to look at information about which hospitals have registered nurses on their wards most of the time. (Registered nurses are those with the most training.)
Here, the University of Illinois at Chicago Medical Center, Children's Memorial Hospital and the University of Chicago Medical Center stand out. Among institutions at the bottom of the list, Methodist Hospital of Chicago and La Rabida Children's Hospital are most likely to use nurses' assistants, the least trained nursing personnel.
People shouldn't jump to automatic conclusions about those rankings or any others presented on the Web site. It may be that using nurses' assistants is appropriate in some cases and less appropriate in others. The only way to find out is to ask a hospital to explain its policies and ask a doctor what the implications are for you and your care.
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