The disturbing reports of fiascoes in our hospitals do get you wondering just which hospitals are safe for your health. Wouldn’t you like to see a scorecard on hospital and doctor performance to consult before admission?
Well, yes, you would. A recent large-scale survey says so.
It finds three-quarters of Australians would be interested in seeing public and private hospitals publish their patient infection rates.
A similar proportion of the 5300 surveyed expressed interest in having doctors publish the number of times they had performed procedures and their success rate.
The publication of patient satisfaction surveys also drew strong backing, as did the suggestion that hospitals should have to publish their readmission rates, which can be a guide to quality of care.
Demand for information about quality of care can overshadow cost worries. The survey found that 68 per cent were interested in being able to consult a list to identify high-charging doctors.
The survey was undertaken in August by Ipsos Australia, whose clients include federal and state health departments and health funds. Ipsos’s project director, Erik Okerstrom, says the survey is framed independently of its clients and in fact similar questions drew a similar level of interest in the previous national health survey in 2005.
With health, Okerstrom says, "you can’t try before you buy". Scorecards would help patients assess service quality when in the past this had been impeded by the venerated status doctors accorded to their work.
The federal Minister for Health, Tony Abbott, has proposed some form of scorecards in the next next health care agreements with the states. The idea has elicited lukewarm support from Labor and scepticism from the Australian Medical Association.
The association’s hospital report card, published last week, saw the solution to hospital havoc almost entirely in providing more resources; that is, money.
But what about quality and safety of services? With the exception of waiting lists, these do not get a mention in the medical association report card. Is this secret doctors’ business?
Despite the popular interest shown by the survey, Australia lags well behind the US and particularly England in letting the public in on how its hospitals and doctors perform.
You can find out, if you ever needed to know, that Bath and Brighton are among places to avoid if you have a health problem while visiting England.
We know this because the Healthcare Commission there has just published its annual ratings on local health service performance. Those at the tourism meccas of Bath and Brighton score a "weak" grading – the lowest of four rankings.
England’s self-described "health-care watchdog" ranks all of the 394 local health trusts and gave only 19 an excellent grade overall, while more than half rated indifferently with "fair" or "weak" gradings on quality of services.
In the wake of the Royal North Shore Hospital saga and other hospital crises, you might say it sounds like Australia.
The big difference is that the British measure and publish the relative performance of their health services and name and shame those below par, a revolutionary idea here. The Australian Medical Association says it would be difficult to make a fair comparison of hospitals with different caseloads and services.
A recent study commissioned by the Australian Centre for Health Research sifted through seven existing schemes to evaluate health care outcomes and found the analyses were not standardised nor available publicly apart from some waiting lists.
NSW Health does publish the results of its "patient safety and clinical quality program", but does not identify hospitals where mistakes occur.
Its last report, last December, tallied 499 serious reportable incidents in 2005-06, up about 10 per cent over 10 years. The incidents include mistakes in treatment, operating or diagnostic services being conducted on the wrong patient and surgical materials left inside patients.
The report says of its figures: "The rising number of notifications in NSW is encouraging and suggests that our safety culture is robust."