New York State’s Cardiac Mortality Ranking | Maternity Information Act Data
Other Sources for Information About Hospitals | Tips for Going to the Hospital
It’s not surprising that there are significant differences in the quality of health care provided by New York State’s private and public hospitals; the Harvard Study of Medical Practice clearly documents it. While the Harvard Study did not disclose the names of the hospitals in the study, the researchers showed that some hospitals have many times the number of injuries resulting from staff negligence than others. Clearly, consumers should thoroughly investigate any hospital that they may be admitted to. Unlike checking a physician’s records and credentials, certain performance records of New York hospitals are readily available.
New York State’s Cardiac Mortality Ranking
The State Health Department annually releases its report on the quality of cardiac surgery in New York hospitals; the report calculated a hospital’s risk-adjusted mortality rate (or risk-adjusted deaths during cardiac surgery) and then listed each of the hospitals accordingly. The most current listing was based on surgeries occurring from 1996 to 1998 but also lists the records of individual surgeons, providing extra, important information for consumers (www.health.state.ny.us/nysdoh/consumer/heart/1996-98cabg.pdf).
The "risk-adjustment" by the Department helps make the listing more sophisticated and accurate. By adjusting for the risk factors associated with the patient (e.g. age, weight, smoker, etc.) the rating system does not penalize hospitals that treat the most sickly individuals in our society. While this information alone should not be the determining factor in choosing a hospital for cardiac surgery, it provides information to help you ask intelligent questions on the quality of care in these hospitals and with specific doctors. The NYPIRG guide contains the most recent cardiac bypass information available from the health department. If you wish to receive the latest cardiac surgery information, contact the New York State Department of Health. NYPIRG has also included the most recent report on the quality of angioplasty surgery in New York’s hospitals. This information is not listed with individual physicians’ records.
Maternity Information Act Data
According to New York State law, hospitals must distribute to all prospective maternity patients, at the time of pre-admission, a short (no explanations) statistical profile of that hospitals’ birth-related practices, along with definitions of those practices. Such practices include Caesarean section, induction of labor, use of drugs to induce labor, number of nurse midwife-assisted births, etc. The information, which may also simply be requested from the hospital, is distributed to hospitals by the state Health Department. You can use this information to discuss hospital options with your physician or midwife.
Other Sources for Information About Hospitals
As a result of access to health information through the Internet, there are new sources of information for hospital patients to examine. Two good ones are www.medicalconsumers.org and www.healthcarechoices.org that allow patients access to important hospital information. New York State provides some limited information available about hospitals. You can look at the information by going to www.health.state.ny.us/nysdoh/healthinfo/index.htm. Those are good sites for all patients to check out since it also has information on state programs such as how to get access to other health information as well.
Tips on Going to the Hospital
The New York State Health Department urges that consumers prepare for a stay at the hospital by finding out:
- o The date you will enter the hospital.
- o What you should bring to the hospital.
- o If you need prior approval from the insurance company.
- o If you will need special help such as interpreters.
- o The plans for your treatment. NYPIRG suggests that any time you enter a hospital, you should plan, prior to admission, the type of care and treatment you want. For example, pregnant women should work out a birth plan with their doctors, in writing, long before they go to the hospital for delivery. Prior to admission is the time to develop a health plan so you can go over the treatment possibilities and grant informed consent to any procedure or medication. When you’re at the hospital and at your most vulnerable, it may be too late.
- o What risks and benefits are involved.
- o When you should expect to feel better.
- o How much your treatment should cost.
- o How long you should expect to stay in the hospital. New York’s law requires that once you are a hospital patient, you receive advance notice in writing telling you when your physician or the hospital staff plans to discharge you, how to appeal if you wish to remain in the hospital, and a special number to call with all problems related to leaving the hospital.
If surgery is necessary, be sure to ask your doctor the following questions:
- o Can the surgery be done on an outpatient (not overnight in the hospital) basis?
- o How much experience has he or she had in doing the surgery that you need? The more experience, the more likely you’ll get a good outcome.
- o How much experience has the hospital had with this type of surgery? Not surprisingly, hospitals that perform procedures many times are the ones that are likely to get it right.
- o Did you get a second opinion that the surgery is needed?
- o Which kind of anesthesia will be used and who will be giving you the anesthesia? You should, in fact, receive a prep visit from the anesthesiologist. This information allows you to check out the anesthesia in advance, as well as check out the anesthesiologist.
State law requires that a hospital staff person meet with you after the administration of treatment to explain your rights as a patient and how to protect those rights. Some hospitals offer a booklet, "Your Rights As a Hospital Patient" which contains all information about your rights under state and federal laws. Also, make sure you select a friend or family member who can advocate for your interests if you become incapable of doing so.
