HEALTH CARE QUALITY: State Study Has ‘Huge Weaknesses’

      California's first "major report" on health care quality, set for release in December, should go beyond assessing coronary bypass surgery in California's hospitals and include other major procedures and doctor-specific records, a Los Angeles Times editorial states. The study, conducted by the Office of Statewide Health Planning and Development and the Pacific Business Group on Health, is similar to a New York state study on coronary bypass surgery in that it "takes into account the age and degree of illness of patients so hospitals aren't penalized for having caseloads of relatively sick people," the editorial notes. However, the editorial points out that unlike New York's survey, which is mandatory for all hospitals, the California study was voluntary, so it includes only "79 out of 118 hospitals in the state that perform more than one heart bypass a week." Moreover, the editorial states, the California study does not assess individual surgeons. Noting that "market pressure" could help solve these shortcomings, the editorial asserts, "Powerful health insurance buyers in the state, like large employers and the California Public Employees' Retirement System, should encourage better studies by refusing to contract with hospitals that do not participate." To help consumers better "distinguish good from bad," the editorial urges Gov. Gray Davis (D) to "call on the state health planning office to measure the performance of individual surgeons and to emulate Pennsylvania, which collects mortality data not just on heart surgery but also on 14 other major conditions and procedures, including stroke, pneumonia, hip surgery and lung cancer" (Los Angeles Times, 10/17).