We have listed information to assist you with Frequently Asked Questions about the New York State Hospital Report Card SM.- Please feel free to contact-us with any further assistance needed.
To compare the performance of each hospital statewide based on one single measure of clinical quality (e.g., mortality rate, medical errors, volume, etc.) – CLICK HERE.
To view all of an individual hospital’s measures of clinical quality on a single page, and to compare all results for up to three hospitals – CLICK HERE.
If you want to evaluate all NHQC measures for up to 3 specific hospitals, click on the compare button.
Then, you’ll see data from all of the three locations you’ve chosen to compare.
If you want to evaluate a specific type of care, click on specific button.
The clinical measures in this report are computed using the federal Agency For Healthcare Research and Quality (AHRQ) Quality Indicators. These hospital-specific measures are computed using hospital data for calendar year 2013 provided by the New York State Department of Health SPARCS unit. The patient survey results measures (e.g., nurse communication) are from the federal Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient survey. Source data can be found at https://data.medicare.gov/data/hospital-compare and are from survey responses during the period from July 1 2013 to June 30 2014.
Many factors affect the selection of a hospital, and these quality indicators are only one source of information to consider. Other factors that may affect your selection of a hospital include what your health plan covers, convenience, where your doctor practices and recommendations from family and friends. Not all providers have the same results. Therefore, you can use this information to talk with your doctor and hospital, and take a more active role in making health care decisions.
For this report, myHeathFinder.comSM used a widely accepted definition of quality care: “The degree to which health services for individuals and populations increases the likelihood of desired health outcomes and are consistent with current professional knowledge.” In other words, quality care meets the needs of the patient and is based on evidence of effectiveness. The performance of the hospitals in this report as suggested by the quality indicators may reflect whether the care ordered by a physician and delivered at a given hospital was consistent with standards of care. However, it also may reflect factors that do not relate to hospital performance, such as patient or physician preference, stage of illness, age, other accompanying illnesses or conditions, or the availability of specialized equipment or doctors. While the data analysis method attempts to adjust for many of these factors, it is not possible to do so perfectly.
You should remember that doctors direct and oversee the medical care that is delivered at hospitals, and prescribe tests, medications and treatments. This report does not separate the effect of the doctor from the effect of the hospital. The quality of care provided in a hospital comes from how well its doctors, nurses, support staff and management work together as well as the technology and other resources available in the facility. If a major change occurs that impacts any of these – such as the departure of a key surgeon or the addition of new technology – the indicators may change dramatically and rapidly. As you talk with your doctor and hospital about your care, ask questions about what changes, if any, have occurred that could impact the care you receive. Medical practice and standards of care change over time as new technology and medicines become available, and as research studies demonstrate effectiveness of specific treatments or procedures. The myHeathFinder.comSM data will be particularly valuable to look at statewide hospital performance trends over time.
What is the source of the data used to calculate these quality indicators?
These data come from information that hospitals record primarily for billing purposes. This type of record, referred to as “administrative data,” consists of diagnoses and procedures along with information about the patient’s age, gender, accompanying medical conditions and discharge status. While administrative data cannot be used as a conclusive source of information on health care quality, it can provide important insights into the quality of care being delivered by hospitals.
Patient and physician names are removed to preserve confidentiality. However, when only five or fewer patients in a facility had a specific procedure, no data are included in the report as a further step to protect confidential patient information. If a hospital had fewer than 30 patients with a specific diagnosis or procedure, no statistical analyses were performed because the results would have been less reliable.
Hospital comments regarding their performance on these indicators are included in the report and are available on the NHQC’s Web site.
What do the hospital-specific comparative reports mean?
For many years, the federal Agency for Healthcare Research and Quality or AHRQ has conducted extensive research into what factors affect quality of health care services, including care delivered in hospitals. Research has confirmed that the rate of patient deaths for certain procedures and conditions may be associated with quality of care. While research can predict an expected range of patient deaths for a given procedure or condition, mortality rates above or below the expected range may have quality implications. For some procedures, research has shown that overuse, under use and misuse (utilization) may affect patient outcomes. For certain procedures, the number of times (volume) the procedure is performed in a hospital has been linked to the patient’s outcome, and the presence of certain types of errors, or high rates of errors may also be associated with the quality of care.
AHRQ developed the AHRQ Quality Indicators (QIs) with the intention that they would be used for researching national, state-wide, regional and hospital-specific performance. They were not developed with the intention that they be used for publicly released hospital quality reports. However, experts and scholars across the nation have determined that the AHRQ Quality Indicators (QIs) represent the current state-of-the-art in assessing quality of care using administrative data. As noted by the Centers for Medicare and Medicaid services, these indicators must be used “cautiously” for public reporting.
This report is based on administrative data. Recording administrative data – or coding – varies among hospitals. Individual judgment often is required. Codes do not provide specific details about a patient’s condition at the time of admission, nor capture everything that occurs during the hospital stay. Especially when reviewing mortality rates, remember that medicine is not an exact science and death may occur even when all standards of care are followed. These reports provide some information about hospital performance, but consider the limitations of the data in your decision-making process. NHQC recommends that consumers discuss these data with their physician.
Are the comparisons between hospitals appropriate?
Because of their expertise, some hospitals treat more high-risk patients, and some patients arrive at hospitals sicker than others. That makes it difficult to compare hospital mortality and utilization rates for patients with the same condition but different health status. To compensate for this fact, the NHQC has “risk adjusted” each hospital’s data to reflect the score the hospital would have had if it had provided services to the average mix of sick, complicated patients. The risk and severity adjustments allow researchers and statisticians to separate the effects the patient and his or her degree of illness have from the hospital stay.
NHQC used a risk adjustment methodology developed by 3M Corporation. Detailed information about the process used to organize and adjust the data for study purposes can be obtained on the AHRQ website.
What do the terms used in the tables actually mean?
Confidence Interval – A range that depicts the likelihood that a hospital’s performance could be influenced by random chance. The larger the range is, the greater the possibility that the hospital’s performance may be influenced by random chance. The range will vary for each hospital depending upon the number of cases or deaths for that condition or for that procedure, and the standard error rate for that year.
Risk-adjusted rate – Adjustments made to the NHQC data based on national patient demographics such as age, gender and medical codes (diagnostic groups) for a specific condition or procedure. The risk-adjusted rate is the best estimate of what the hospital’s rates would have been if the hospital had a mix of patients identical to a national-average patient mix for that year.
Risk Adjustment software developed by 3M Corporation.
