There is increasing interest in using health data to help patients make choices about hospitals. A common approach is to use publicly available billing data from Medicare to compare rates of death and complications among different facilities.
The principal investigator, Harlan Krumholz, M.D., associate professor of internal medicine, cardiology and in the Department of Epidemiology and Public Health, and his colleagues, conducted a study of HealthGrades.com, Inc., one such rating system, which is promoted on a popular Internet website. The Yale group focused on the ratings of hospitals for the care of patients with heart attacks and studied 3,363 hospitals to determine whether hospital ratings from the website provided useful information to patients.
The website used the billing data to classify hospitals as having had better than expected quality (five-star) or worse than expected quality (one star), based on their mortality using an unpublished mathematical model.
The Yale investigators compared HealthGrades.coms hospital ratings with detailed medical record information that was collected from hospitals as part of a federal project examining the quality of care provided to elderly patients hospitalized for a heart attack.
"The results were mixed," Krumholz said. "If you aggregate the hospitals based on their ratings, there is a gradient of risk of death. Patients at five star hospitals did have a lower rate of dying from heart attacks than patients treated at one star hospitals. For the use of medications endorsed by the experts, the higher rated hospitals did not always excel in their use of treatments, and in some cases the lower rated hospitals did better."