New health care service database compares local hospitals, health centres against peers
Residents from around Newfoundland and Labrador and across the country are now able compare how their local health care services stack up against other centres and regions with similar characteristics.
The Canadian Institute for Health Information (CIHI), an independent, not-for-profit corporation, released a new online tool earlier this month that measures health care information on 21 clinical indicators and nine financial indicators for large, medium and small size hospitals and care facilities.
The tool allows people to compare data from these indicators to other hospitals, regions, provinces and the national average. Data can also be compared to previous years.
John Wright, President and CEO of CIHI, said in a press release, “This information fills an important gap in health system information.
“We are now able to report on aspects of both clinical and financial performance across all provinces and territories for more than 600 acute care hospitals in Canada.”
Jeremy Veillard, Vice President, Research and Analysis at the not-for-profit corporation said, “When hospitals are grouped according to their peers, we see a wide range of results in performance.”
A survey by the Pen found that the Charles C. Curtis Memorial Hospital (CCCM) in St. Anthony improved significantly last year in indicators for readmission and mortality rates after heart attacks.
The 30-day mortality rate after heart attacks dropped substantially, from 17 patients out of 100 in 2009/2010 to 3.19 in 2010/2011.
This number is less than half the Newfoundland and Labrador average of 8.87 and the national average of 7.6 readmissions 100 patients.
Labrador Grenfell Health (LGH) averaged a rate of only 2.74 - almost one third of the provincial average.
CCCM also came out ahead of provincial and national averages in readmission rates in pediatrics, surgical, and knee-replacements.
The Strait of Belle Isle Health Centre in Flower’s Cove fared better than provincial and national averages for readmission rates overall and after medical procedures.
Labrador South Health Centre in Forteau had an exceptional rate in 30-day readmissions for pediatrics with 0 patients out of 100 in 2009/2010, however it was slightly above provincial and national averages for readmission rates overall.
White Bay Central Health Centre in Roddickton had the highest rate among its peers for 30-day readmission rates overall, in pediatric cases, and medical episodes, although these were all recorded at low volumes.
CCCM and LGH also performed significantly better than their peers in “Nurse-Sensitive Adverse Events for Surgical Patients,” which studied the rate of events such as urinary tract infections, in-hospital fractures and pneumonia.
The hospital had less than half of the provincial average with a rate of 18.99 events per 1,000 patients, compared to 48.97 in NL, and it was lower than the Canadian average of 36.15, although CCCM was slightly above provincial and national averages for the same indicator for medical patients.
In terms of getting the most bang-for-your-buck in health care spending, CCCM was higher than the provincial and national averages for cost per weighted case, which measures the ratio of the hospital’s total acute inpatient care expenses to the number of acute inpatients.
CCCM spent $9,937.28 as a cost per weighted case, compared to the provincial average of $6,250.37 and national average of $5,167.59.
LGH was just above the provincial average with a cost per weighted case of $6,951.37.
Labrador South Health Centre had the lowest cost per weighted case amongst its peers with the slim total of $69.88.
The highest among the same peer group was Dr. Walter Tempeleman Health Centre in Bell Island with a total of $16,263.82.
However, CIHI explains that regional costs tend to be lowest in western provinces and highest in territories due to the smaller size of hospitals and their remoteness. This logic could also be applied to the LGH region and other rural areas around the province.
For the study, hospitals across the country were assigned to peer groups according to size.
According to CIHI, this analysis enables peer comparisons in order to improve quality of services.
“Through comparison they are able to learn from each other,” said Veillard.
“This has the potential to move the system as a whole toward even more transparency and accountability—and more importantly, to provide even better, more cost-efficient care to all Canadians.”
Cecile Hunt, CEO of Prince Albert Parkland Health Region in Saskatchewan, praised the inclusion of small hospitals in the press release.
“The fact that CIHI has been able to include small hospitals is very important. Almost 60 per cent of hospitals in Canada are smaller facilities, and up until now there has been minimal information available to them about how they are performing in relation to their peers.”
“Whether people use the information to look at hospital care or administration, CIHI’s new web-based resource helps facilities across the country better understand their performance in comparison with their peers,” says Veillard.
The web-based tool can be viewed on CIHI’s website, www.cihi.ca.
CIHI is funded by federal, provincial and territorial governments to provide information on Canada’s healt system and health care.
The organization is guided by a Board of Directors that includes health leaders from across Canada.
According to their website, their vision is “to improve Canada’s health system and the well-being of Canadians by being a leading source of unbiased, credible and comparable information that will enable health leaders to make better-informed decisions.”