Life or Death
What’s at stake when choosing your hospital
GOING to a hospital is taking your life in your hands. New research shows patients treated at the worst hospitals are three times as likely to die as patients with the same health problem treated at the best hospitals. Yet most people pick a hospital based on convenience, a friend’s recommendation or where their doctor practices.
That’s a mistake: In truth, your doctor won’t even be treating you. An in-house physician called a “hospitalist” who has never met you will take over. That’s why you need to find out which hospital has a record of success in treating your problem.
According to the new research in the journal PLOS One, getting the facts on hospital quality is especially important if you have heart problems. Go to the wrong hospital with a heart attack — what doctors call an acute myocardial infarction — and your risk of survival is cut by more than half.
Also beware of huge differences in patient safety. The same new research shows that the risk of contracting a bloodstream infection is 10 times higher at certain hospitals than others.
If you live on the Upper East Side and need bypass surgery or a new heart valve, where should you go? Mount Sinai Hospital is rated eighth in the nation in cardiology and heart surgery, according to US News & World Report. That Web site rates hospitals all across the nation, and it’s free.
A different Web source, Consumer’s Checkbook (subscription required) also gives Mount Sinai a top rating — five stars — for bypass and valve surgery.
That’s a far cry from another Upper East Side hospital, Lenox Hill, which is scored “average” by US News for valve and bypass surgery, and earns only one star from Consumer’s Checkbook. But that’s only for heart care. Lenox Hill earns five stars for gallbladder surgery.
So it varies. If you’re in Los Angeles and develop heart problems, you’re better off at Cedars- Sinai Medical Center, rated 10th in the nation in cardiology by US News, rather than St. Vincent’s Medical Center, which gets below-average marks for heartvalve and bypass surgery.
What about suburban hospitals? Stamford Hospital and Greenwich Hospital, both in Connecticut, are considered “high performing” by US News for treating heart failure and chronic obstructive pulmonary disease (COPD). Greenwich gets far better ratings for hip-replacement surgery than Stamford, but still isn’t tops. Back in the city, look at Hospital for Special Surgery, rated No. 1 in the nation for orthopedics.
Stamford and Greenwich hospitals earn A ratings from Leapfrog, which grades hospitals on patient safety. As many as 440,000 patients a year die in the United States from medical errors, injuries and infections caused by hospital care. That’s why this safety grade can’t be ignored. Yet New York City’s toprated medical centers — Mount Sinai, New York Presbyterian and New York University Hospital — get only C grades for safety. Hospitals in cities like Boston, Hartford and Chicago do far better.
This week the federal government announced it’s penalizing NYU Hospital and Mount Sinai, along with Kings County Hospital in Brooklyn, Montefiore Medical Center in The Bronx, North Shore University Hospital on Long Island and 764 other hospitals across the country for having too many infections, bed sores, falls and other complications. These hospitals — about one out of every four in the United States — will lose 1 percent of their Medicare payments for a year.
The risk of infection and medical mistakes adds to the stress of being hospitalized. That gets even worse once you discover your personal doctor is MIA. About three-quarters of hospitals now use hospitalists, doctors paid by hospitals to supervise patient care. The upside is hospitalists are on-site. They also tend to spend less on care and discharge patients sooner.
The downside is they don’t know you or most of your medical history, and can’t provide continuity of care once you leave the hospital. Worst of all, during one of life’s most trying moments, you’re relying on a total stranger, not your trusted doctor.
All the more reason to choose your hospital carefully. Easy to say, ObamaCare plans severely limit hospital choice, often excluding the highest-rated hospitals and specialty hospitals. That’s dangerous, especially for patients with serious illnesses and pre-existing conditions.
Whatever comes after ObamaCare should guarantee hospital choice. Your life could depend on it.