Mining the HospitalCompare Database for Health Stories

Some interesting new data over at Medicare's Hospital Compare database released Wed. is worth mining for enterprise stories about how people receive treatments for heart attacks and other medical conditions at hospitals in your community.

Much of the immediate media coverage (ably rounded up by Kaiser Health News) focused on some quick-hit comparisons of local hospitals, but there are deeper stories to be done.

HospitalCompare once only provided quality data for hospital inpatients. Now, it incorporates outpatient data, including:

• rates of outpatient MRIs for low back pain,
• how many patients are re-tested after a screening mammogram (with a high number of retests possibly signaling poor reading of mammograms, poor coordination of care, or exposure to too much radiation)
• measures of how well outpatients (including emergency room patients) are treated for potential heart attacks
• measures of how well surgical outpatients are protected from infection
• 30-day mortality rates for heart attack patients

I participated in an AHCJ-sponsored conference call for reporters Wed. on how to review the new data and came back with some caveats.

First, said Dr. Barry Straube, chief medical officer for the Centers for Medicare and Medicaid Services, people using HospitalCompare (and that includes journalists) should not use only one or two measures to evaluate a hospital's overall performance.

Second, Straube urged caution in drawing conclusions from the medical imaging data, which is in its first year of reporting and may pose validity and data questions.

With that in mind, I queried HospitalCompare on two Los Angeles-area hospitals to see what their statistics showed. You also can download parts of the database to do some serious number-crunching, but you'll need a powerful computer and a working knowledge of Microsoft Access.

I looked up Cedars-Sinai Medical Center in Los Angeles, which serves many affluent patients, and Los Angeles County/Harbor-UCLA Medical Center, which does not.

Here are some possible stories the data pointed to. As with many other kinds of health data, of course, these factoids are just the start of your reporting.

1. Cedars-Sinai does better than the national average at keeping patients alive for at least 30 days after a heart attack or heart failure. LAC/Harbor-UCLA does not. Why? Are LAC/Harbor-UCLA patients sicker? Do they leave the hospital sooner? Does Cedars-Sinai have different treatment protocols?  

2. Only 3.4 percent of outpatients at LAC/Harbor-UCLA received follow-up mammograms after leaving the hospital, which may indicate too little follow-up, compared to 12.2 percent of Cedars patients. Is the lack of insurance for many LAC/Harbor-UCLA patients a factor?

3. About 22 percent of Cedars-Sinai patients received expensive MRIs for back pain without first trying simple treatments like physical therapy. (LAC/Harbor-UCLA didn't report this measure.) That 22 percent is high compared with a few other Los Angeles-area hospitals. Question: who owns and profits from the MRI machines that scan Cedars outpatients, and are too many MRI scans being performed?