Before your next hospital stay, visit the Web to see how local institutions stack up—but understand that the information you’ll find has limitations.

When you put your health and well-being in the hands of a hospital staff, you’ll want to know the staff will be caring and attentive, will communicate with you clearly—and will keep those hands clean.

You’ll need to know more than that, though. For example, does the hospital follow recommended guidelines for handling certain treatments? Does it have low rates of complications and mortality? Are its costs reasonable? You can find information like this on the Internet for each hospital in your area.

The hospital you choose can influence how you fare after treatment. For instance, hospitals that do more of the same surgeries and procedures tend to have better patient outcomes. And one study by HealthGrades, a major hospital rating service, found that patients in its top-rated U.S. hospitals had only half the risk of dying during their stays compared to average hospital mortality rates.

Surf with Caution
Web sites such as the ones listed here can help you compare your local hospitals or find a center of excellence. They may be worth consulting—as long as you visit more than one hospital rating site and have a good sense of what the data means before basing a decision on it. That’s because much of the information you come across may be confusing and misleading.

Even the most respected sites present data that contains flaws, research suggests. One study, for example, found that hospitals with top safety ratings had about the same in-hospital death rate as low-ranking hospitals. Different rating sites tend to draw on different data, so a facility can receive a lofty rating from one site and a middling rating from the next. Information often isn’t current. Then again, many hospitals choose not to report some or all of their data to a rating service, making a comparison difficult or impossible.

Many experts stress that it’s critical to consult more than one rating service and then ask your doctor about what you learned online. Your physician is likely to have the inside scoop on the quality of care in local hospitals. He or she can help you make sense of the data and make an informed choice.

For example, you may discover that your favorite teaching hospital has a relatively high rate of patient deaths and long lengths of stay. Your doctor may explain, however, that this hospital typically treats patients with more serious conditions, and its data hasn’t been adjusted by the rating service to reflect these increased risks.

Getting Started
Most Web sites that rate hospitals are very simple to use: Just plug in your city and state or ZIP code, and click a button. Examples include:

• Hospital Compare. This site, created by the Centers for Medicare & Medicaid Services, the Department of Health and Human Services, and others, shows how well hospitals care for patients with certain medical conditions or surgical procedures and how patients rated the quality of care they received. Visit www.cms.hhs.gov and search for “hospital compare.”
• The Joint Commission. Its Quality Check service tells if a hospital is accredited by The Joint Commission and is committed to meeting certain quality and safety standards. It also shows how the hospital compares to other accredited organizations in terms of safety goals, quality improvement goals, mortality rates, and patients’ hospital experiences. Go to www.jointcommission.org.
• The Leapfrog Group. This site will produce a page of comparison graphs for all the hospitals in your area who took part in Leapfrog’s survey. This reveals at a glance how well each hospital meets certain safety standards for patients overall and for certain procedures. You’ll find the site at www.leapfroggroup.org/cp.
• HealthGrades. This service gives annually updated cost information and quality ratings for 5,000 hospitals. Compare hospitals according to procedure or diagnosis, or by awards received for excellence. Check it out at www.healthgrades.com.
• U.S. News & World Report. Each year U.S. News screens nearly 5,000 U.S. hospitals and details the strengths of those that make the grade. You'll find that list at http://health.usnews.com/besthospitals. Children’s hospitals are ranked at http://health.usnews.com/pediatrics.

More to Explore
Also check the Internet for regionally based comparison sites, such as www.njhospitalpricecompare.com in New Jersey and, in California, www.calhospitalcompare.org.

Then, of course, you can survey the opinions of family and friends. Consumer ratings sites, such as www.wheretofindcare.com, are another forum for individual patients to celebrate their favorite facilities or air their grievances. Just be aware that a surgical horror story is only one person’s experience.

A tour of the hospital itself can tell you a lot, just from the sense you gain of its cleanliness.

Ask important questions, such as: Can your own doctor admit you to this hospital as a patient? (If your doctor doesn’t have privileges, another doctor will need to provide your care.) Is this hospital on your health plan’s network of providers? If not, you may have to pay a lot more out of pocket for treatment.

Combine all this detective work with advice from your doctor, and you’ll know you’ve done all you can to place your health and well-being in good, clean hands.

Making Sense of the Data
Hospital rating services compare data, such as:

• Cost of care—for example, a hospital’s average cost for a certain condition or procedure. These costs can vary widely from hospital to hospital.
• Process of care measures, which show how well a hospital follows generally recommended treatment guidelines.
• Complication rate—for example, the percentage of patients who come down with pneumonia or an infection after major surgery.
• Mortality rate—a hospital’s overall death rate among inpatients, or its death rate for certain procedures.
• Readmission rate—the percentage of patients who, after discharge, must be readmitted to the hospital for additional care.
• Length of stay—for example, a shorter hospital stay may suggest the facility is more efficient in its care or has fewer treatment complications.
• Volume—how many of a particular procedure the hospital does.
• Patient satisfaction—such as how well doctors and nurses communicate with patients, how well pain is controlled, and how clean the patients’ rooms are.

Polly Turner is a feature writer for Vitality.

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