CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

August 5th, 2011

USA Today Finds Disparity Between Hospital Performance and Public Perception

Patients may think they’re going to a high-quality hospital when in fact they’re not, according to an analysis of Medicare data appearing in USA Today, by reporters Steve Sternberg and Christopher Schnaars. The USA Today website also contains an interactive graphic with a user-friendly interface, to help readers compare hospital death rates and readmission rates for MI, HF, and pneumonia.

A pointed example of the gap between perception and performance is Maimonides Medical Center in Brooklyn, New York. Although it gets low rankings from patients, who think it’s dirty and noisy, the article notes:

Medicare data released today shows that Maimonides is one of 13 of more than 4,700 hospitals nationwide with below-average death rates for all three conditions: 11.2% for heart attacks, compared with a national average of 15.9%; 7.3% for heart failure, compared with 11.3%; and 6.8% for pneumonia, compared with 11.9%.

By contrast, the USA Today writers also identified more than 120 hospitals with outcomes significantly below the national average for MI, HF, and pneumonia that nevertheless received high praise from patients.

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4 Responses to “USA Today Finds Disparity Between Hospital Performance and Public Perception”

  1. Judith Andersen, AB, MD says:
    August 10, 2011 at 2:14 pm

    Patients and families are often ill-equipped to assess quality of care. They respond to compassion, provision of comfort, quality of food and personal interactions, hospital amenities — not trivial things, but, without medical background or experience, do not have the ability to assess objectively the quality of care they or family members receive. Some of the least physically attractive hospitals country-wide provide the best care, and, conversely, some of the most “patient-friendly hospitals provide he worst: the bottom line: guts and professionalism of doctors, nurses, support staff matter– not necessarily surroundings or parking passes.

    Competing interests pertaining specifically to this post, comment, or both:
    I have no conflict that I’m aware of.
    I’m a physician in an inner city Detroit hospital complex that provides both great and terrible care, because it has superb academic and private physicians and terrible private physicians occupying the same turf. Amenities and nursing care are excellent, physician expertise is variable in the extreme. Many patients think they are being provided excellent care because their incompetent private physicians are well-dressed and polite, although lacking the most basic medical skills.

  2. Alfonso E. Sierra, MD says:
    August 11, 2011 at 5:52 pm

    The public here and elsewhere is so susceptible to advertisement, that this does not surprise many of us. Multiple articles in newspapers of name, despise physicians that are excellent medicine-wise but “lack” or have “deficient” manners and don’t bend over every time to beg for the acceptance of advice that doesn’t go along with the “mainstream view” about issues that like so many things in our profession are not always fully black or white (or should I say green and brown?).

    Competing interests pertaining specifically to this post, comment, or both:
    None

  3. Anil Virmani, MD, DRM says:
    August 11, 2011 at 11:59 pm

    In India, we have a number of state-of-art corporate hospitals ranked amongst the best, because of facilities available & their excellent marketing, but many patients do complain of lack of “human touch” and being overcharged.On the other hand, we have many good government hospitals & private hospitals which may lack in all the latest equipments, but do make up with a lot of “tender loving care”. How do you compare and rate such services ?

    Competing interests pertaining specifically to this post, comment, or both:
    I am a consultant physician who has to depend on both these types of medical services for my patients.

  4. Saurav Chatterjee, MD says:
    August 13, 2011 at 3:11 pm

    The so called ‘human touch’ and patient perceptions have time and again been proven to be falsely indicative of the quality of care as well as hard clinical outcomes for individual doctors as well as for hospitals-ref: http://intqhc.oxfordjournals.org/content/8/5/467.full.pdf
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2384287/
    Inspite of these repeated measures and data-always in spotlight is the ‘art’ of medicine….to the extent that 3 out of 6 core competencies in ACGME training programs focus on what is perceived as the ‘soft skills ‘ of a trainee-isnt it time to focus more on the clinical knowledge,skills,scores in standardized exams(over a period of time), research productivity,and place less emphasis on ‘perceptions’ which may well be biased….I feel this current assessment model is conducive to development of a breed of ‘apple polishers’ whose greatest claim to fame probably was to please someone important……I would love to get treated by a doctor who has great ‘human touch’ but in a crunch situation-I think I would go for someone with better documented outcomes.

    Competing interests pertaining specifically to this post, comment, or both:
    None.