Studies Examine Metrics Used to Measure Hospitals

Metrics used to measure hospital performance have drawn scrutiny in two recent studies.

“Patient satisfaction” has little correlation to other measures of quality healthcare outcomes, according to a study by researchers at the Johns Hopkins University medical and public health schools. Another study published in the New England Journal of Medicine investigated “community benefit” by hospitals, and while it did not find fault with the metric, the study found the amount of community benefit provided by not-for-profit hospitals wildly variable.

In the patient satisfaction survey, the researchers found “little evidence supports its ability to predict the quality of surgical care,” the authors of the study wrote. One of the authors, Dr. Martin Makary, told Kaiser Health News that patient satisfaction gets a lot of attention by consumers because it is metric available to the public. “It’s going to mislead patients because they’re going to think the hospital with the best lobby and the best parking and customer service is going to have the best heart surgery,” he told the website.

Dr. Makary said he still considers patient satisfaction a valuable area to measure hospital performance, but that it receives too much emphasis compared to other measures such as metrics for surgical quality.

In the community benefit study, the researchers examined tax returns of 1,800 not-for-profit hospitals, basically repeating the research of the American Hospital Association (see link below). The results were roughly the same. According to the researchers:

Tax-exempt hospitals spent 7.5 percent of their operating expenses on community benefits during fiscal year 2009. More than 85 percent of these expenditures were devoted to charity care and other patient care services. Of the remaining community-benefit expenditures, approximately 5 percent were devoted to community health improvements that hospitals undertook directly. The rest went to education in health professions, research, and contributions to community groups. The level of benefits provided varied widely among the hospitals (hospitals in the top decile devoted approximately 20 percent of operating expenses to community benefits; hospitals in the bottom decile devoted approximately 1 percent). This variation was not accounted for by indicators of community need.

The study concluded that “tax-exempt hospitals varied markedly in the level of community benefits provided,” but that in all cases little was spent on community health improvement

Previously:

Patient Finance Benchmarks: Tax Returns Shed Light on Hospital Charity Care Thresholds