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HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA ISSUES STATEMENT

 HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA ISSUES STATEMENT
 PITTSBURGH, March 27 /PRNewswire/ -- The Hospital Council of Western Pennsylvania today issued the following comments on the Hospital Effectiveness Report.
 "The Pennsylvania Healthcare Cost Containment Council (HC4), based in Harrisburg, Pa., is publicly releasing the Hospital Effectiveness Report for Region One on Friday, March 27. Although improvements to the report have been made, area hospitals are still concerned that the report will be misinterpreted by health care consumers and that the report does not effectively caution consumers about its own limitations.
 "Area hospitals note that many improvements have been made to the report, some of which were suggested by hospital and physician representatives. For example, HC4 has taken a first step toward adjusting their analysis for patient ages; has removed patients with cancer from non-cancer diagnosis-related groupings (DRGs); and has greatly improved the narrative descriptions of column headings on the report's charts.
 "Despite these positive changes, there are a number of refinements and improvements that area hospitals feel still should be made to minimize misinterpretation of the report. Neither western Pennsylvania hospitals nor the HC4 wants this report misinterpreted.
 "Hospitals are concerned about three primary areas:
 "1. The report does not measure or allow a comparison of the quality of care provided by southwestern Pennsylvania hospitals. Quality of care cannot be measured by simply counting the number of deaths in a hospital or by counting the number of patients who are medically unstable during their first week in the hospital (major morbidity) and then comparing those numbers to averages.
 "For this type of analysis, to approach assessing quality of care, it would be necessary to also carefully examine patient risk factors and characteristics that can vary from hospital to hospital and that can affect mortality and medical stability of patients.
 "For example, although HC4 has adjusted for patients age 65 and older and for patients age 80 and over, the adjustment is inadequate to capture the overall affect of age on mortality.
 "Similarly, the report needs to address other patient characteristics. For example, a hospital that admits high-risk patients due to its medical specialists and technical capabilities, would also most likely exhibit a higher mortality rate.
 "2. Particular attention should be paid to the interpretation of the plus and minus signs on the tables in the report. Although a plus or a minus sign tends to suggest that something is good or bad, in this report it only indicates that the observed value is different than the average value and that the difference is probably not due solely to chance.
 "This means that the difference is probably due to one or a variety of factors. However, the cause for the difference is not known. In fact, HC4 has recognized this on page 7 of the Region One report. The report notes, under the description of the plus and minus signs that '...the difference could be related to a variety of factors such as quality of care or other medical factors not measured in this report.'
 "3. Finally, charges vary so much between hospitals and cannot be used to compare hospitals. One of the major reasons hospital charges vary from one another is that there is no standard way of calculating charges.
 "The method used by one hospital to calculate charges may be completely different from the way another hospital calculates charges. Some hospitals include such things as radiology services, laboratory services, rehabilitation services, medical education expenses and anesthesia services when calculating charges. Other hospitals do not.
 "Although most hospitals include in their charge calculations an amount to help cover the costs of providing care to those unable to pay, this amount may differ. Some hospitals have a large number of patients who are unable to pay and others have fewer of these patients.
 "Therefore, comparing one hospital's charges to another is like comparing apples to bananas.
 "The Hospital Effectiveness Report does display hospital average charge information, but unless the health care consumer knows what is included in these charge calculations, the charge figure should not be used to compare one hospital to another."
 -0- 3/27/92
 /CONTACT: Bill Cross, senior director, administrative services, of The Hospital Council of Western Pennsylvania, 814-231-1370/ CO: Hospital Council of Western Pennsylvania; Pennsylvania Healthcare
 Cost Containment Council ST: Pennsylvania IN: HEA INS SU:


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Date:Mar 27, 1992
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