hospital impact

by Nick Jacobs

From the local paper, " Hospital A's mortality rates improved, while Hospital B, Hospital C and Windber Medical Center received poorer marks. The truth, the whole truth and nothing but the truth, . . . or so it would seem.

As many of you know, we are very passionate about transparency in health care and, as a Planetree Hospital, we are committed to demystifying health care. One of the problems that we face, however, is a nuance problem.

We have a palliative care unit, a hospice that is utilized by a five county area. It is a center that provides pain control, respite and end of life care. My opinion of this service is that every hospital should offer it to every family. Bottom line though is that each year, our hospital is penalized statistically because of the number of deaths that occur. Why does this happen? It is because the conventional thinking in this country is still that, even if a patient has a do not resuscitate order, death is not acceptable and must be statistically noted as something bad.

Consequently, even though patients elect to come to our unit to die surrounded with dignity and peace and embraced by their loved ones, their death shows up as a negative State statistic without differentiation.

If the terminal patient was there because of heart failure, the ultimate end of that condition is not life, it is, in fact, death. Unfortunately, the statistics will show an inordinately high number of deaths for heart failure in the category that graphically depicts our medical center's death rate. Then the newspaper will cover this statistic, and we will, once again, attempt to respond to the public by explaining what hospice services are and how their impact on our numbers should be calculated.

As Ronald Reagan once said, "Here we go again."

Transparency in death rates must be carefully monitored so as not to penalize those facilities that help families by providing transitional hospice services. We know of some heart centers that will not operate on patients with high risks because it will skew their statistics.

Numbers can do whatever you want them to do, and we want them to be honest and carefully depicted to demonstrate truth and clarity. We're not blaming the press, but we are, once again, questioning the Health Care Cost Containment Council's mechanism for production of these statistics.