Navigating the Health Care System

Advice Columns from Dr. Carolyn Clancy

Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.

Doing a little homework before you choose a hospital can do more than give you peace of mind. Choosing a hospital that scores well on quality can make it easier—and safer—for you to recover from a serious event, like having heart surgery, or a routine one, like having a baby.

As a physician, let me emphasize that if you need emergency hospital care, go to the closest hospital. But if you aren't facing an emergency, take time to do some research.

The good news is that there is a lot of information to help you make an educated choice about which hospital to use. But to get the most complete picture of the best hospital for your needs, it's helpful to check several resources. It's also a good idea to ask your doctor and your friends for their advice and why they prefer Hospital A over Hospital B.

To get an overall view of quality, you might start by reviewing hospital "report cards" that private groups produce. Hospital "grades" are based on different measures, and each group emphasizes some over others. For example, some grade hospitals on what doctors think of them, how many hospitals use computers to order drugs, and how well patients recover from different kinds of surgeries.

One downside to these report cards is that hospitals are not required to participate in them. This could mean there are no data about a specific hospital. Another problem is they often use data that are several years old.

If you have already picked a hospital based on your insurance plan or your doctor's advice, you can find out more about its overall quality of care. You can also find out how well it compares with other hospitals in your area.

The Federal Government has a useful source of information on hospital quality. The Hospital Compare Web site lets you find out how well hospitals care for adult patients with certain conditions. The vast majority of hospitals—about 90%—report their quality data. Even if you are not covered by Medicare, this information can help you compare the quality of care that hospitals provide.

Hospital Compare lets you:

  • See how often a hospital gives the right treatments for certain conditions—like heart attacks, heart failure, and pneumonia—or procedures—like preventing surgical infections.
  • View the results of care or treatment for certain conditions or procedures.
  • See how much Medicare paid hospitals for certain conditions and procedures.
  • Find out what hospital patients said about the care they received during a recent hospital stay. Their experiences are an important part of good quality care. Feedback from patients to more than 2 dozen questions is currently available. By the end of the year, information from most of the Nation's hospitals will be available on the Hospital Compare Web site.

My Agency developed the survey, released in April, which asked patients about their hospital experiences. We also put together a checklist of questions that you can use to help you find a good hospital. These questions can also help you decide if you need more information.

The Joint Commission's Quality Check Web site also lets you search for information on any hospital in the United States. This is a national, nonprofit organization that "accredits" hospitals to make sure they fully comply with all of the group's quality standards. The Quality Check Web site can tell you whether a hospital is accredited and will identify hospitals that have not met quality standards.

You can use the Quality Check Web site to:

  • Find out the hospital's quality performance from previous years.
  • Learn whether the hospital offers certified programs in specific disease areas, such as stroke care.
  • Get data on the hospital's National Quality Improvement Goals. This tells you about the quality of care for several specific conditions, including children's asthma, heart attack and heart failure, pneumonia, pregnancy, and preventing surgical infections.

Measuring hospital quality isn't a perfect science. But we have a lot of information today to help you make an educated decision. That's the best decision for your peace of mind—and for your health.

I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.

More Information

AHRQ Podcast
Consumer Tips for Choosing a Hospital  (Transcript)

Hospital Compare
Find and Compare Hospitals
http://www.hospitalcompare.hhs.gov/Hospital/Search/Welcome.asp

The Joint Commission
About Quality Check
http://www.jointcommission.org/QualityCheck/06_about_qc.htm

Hospital Report Cards: Making the Grade
Harvard Medical School Family Health Guide
http://www.health.harvard.edu/fhg/reportcards.shtml

Page last reviewed June 2008
Internet Citation: Do Your Homework Before You Choose A Hospital. June 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/061708.html