Higher Risk Of Complications Seen At Teaching Hospitals

Although many patients prefer to receive their care at teaching hospitals, believing these facilities offer advanced treatment options, recent research has found higher risks for complications at teaching hospitals.

Known for offering higher tech, more advanced treatments for more challenging diseases, it seems that, according to Medicare’s first public review of hospital records on patient safety, teaching hospitals may not be as safe as long believed, said The Washington Post. Medicare began publishing complication rates as a method in which to create hospital payment rates, although leaders at some of the country’s more renowned hospitals object to the practice, said the Washington Post. Hospitals say the accuracy and fairness of the efforts, which come down to payment, are in question.

Georgetown University Hospital; Washington Hospital Center; the Cleveland Clinic; Mount Sinai Hospital in New York City; and Geisinger Medical Center in Danville, Pennsylvania are among the hospitals with significantly more complications based on data the Medicare program evaluates, said The Washington Post.

The issue involves the 2010 federal health-care law in which Medicare reimbursement will be linked to a number of elements such as how patients rate their stays, patient readmission and mortality rates, and how closely hospitals follow basic care guidelines, said The Washington Post. The administration believes that including financial incentives into Medicare will better ensure that hospitals will reduce costs while improving patient treatment. Medicare, which covers 47 million senior citizens and disabled people, is the world’s largest insurer.

Medicare, which will be initiating the program in October, is prepared to include additional patient safety measures in 2013. Meanwhile, the debate now includes independent experts and those who have sought to improve patient safety. For instance, said The Washington Post, a panel created by the National Quality Forum last month, recommends not using the patient safety measure for payment “due to concerns about the reliability of the data sources,” said Atul Grover, head of public policy at the Association of American Medical Colleges.

Some hospital officials at hospitals with high complication rates say the measures do not take into account the fact that their hospitals treat the most complicated cases and sickest patients, noted The Washington Post. Medicare’s information appears on its Hospital Compare Web site (hospitalcompare.
hhs.gov), which is available to consumers and allows for insurers to add factors concerning how much to pay facilities.

Barbara Rudolph, senior science director at the Leapfrog Group, a hospital evaluator, said the high complication rates at big teaching hospitals might be real. “It’s much more difficult in a large institution to adequately train everyone to do the right thing…. You tend to have more residents and fellows flowing through,” she noted, said The Washington Post. Meanwhile, Cleveland Clinic officials say its high rates of accidental tears and lacerations and serious blood clots are due to hyper vigilance, over-documenting all aspects of a case, wrote The Washington Post.

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