REPORT CARDS: May Not Adjust For Patient Differences
A study in this week's Journal of the American Medical Association concludes that hospital and health plan report cards may not adequately account for the differences in patient populations. Researchers at Case Western Reserve University specifically looked at Cesarean section rates at 21 hospitals in the Cleveland area. They found C-section rates "varied from 6% to 26.5%." But when "39 factors affecting the populations served by the hospitals" were taken into account, "the researchers found the rankings biased." After adjusting for risk factors such as maternal age, the "rankings of five of the hospitals changed substantially and the adjusted rates changed by at least 10% in 12 of the institutions" (Reuters/Nando.net, 6/24).
The study authors conclude: "Whereas many professional societies readily acknowledge that Cesarean delivery rates in the United States can be safely reduced, our findings suggest that hospital comparisons or profiles of Cesarean delivery rates that fail to account for patient characteristics that increase the likelihood of Cesarean delivery may be methodologically biased and may mislead health care purchasers" (Aron et al, 6/24 issue). Click here to see an abstract of the study.