HealthGrades is one of those innovations of modern health care that helps patients choose hospitals with the best safety records.
Trouble is, the more you look at the website's hospital rankings, the more questions it raises.
Let's imagine a patient is considering knee replacement surgery at Regions Hospital in St. Paul. Naturally, he'd want to check HealthGrades' latest data, released this week.
The results would appear, and he'd learn that Regions received only one of five stars. The hospital reported complications in 13.67 percent of 439 total knee replacements from 2008 to 2010. Based on the relative health of those patients, the complication rate should have been only 10.47 percent.
What next? The patient would nervously click on other metro hospitals, searching for a five-star rating and a low complication rate. He'd be disappointed. Most local hospitals have one-star ratings. Four have three stars. Only one, North Memorial Medical Center in Robbinsdale, gained top marks.
Even the august Mayo Clinic got only three stars.
But it doesn't mean the Twin Cities area has inferior hospitals. Most of them would receive five stars for the quality of their heart-failure care -- when almost half the nation's hospitals only received 1 star.
Turns out, results vary substantially by region. Five stars is the average for hospitals performing joint replacements in nine of 11 regions in California, and in three of five regions in Wisconsin.
Exactly why so many hospitals in the Twin Cities lag on knee replacements -- a very common procedure -- is complicated.
But it's clear that, at the local level, grading can seem a bit skewed. For patients, this doesn't debunk for-profit HealthGrades. Comparing observed and expected rates of surgical deaths and complications is a great way for the public to evaluate hospitals.
Just don't forget the regional context. A hospital rating means little without it.
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