The federal government this month has silently stopped publicly reporting incidents such as hospitals leaving foreign objects in patients' bodies, and other life-threatening mistakes, USA Today reports.
The Centers for Medicare and Medicaid Services (CMS) denied it was making the change last year.
CMS removed the data on eight avoidable "hospital acquired conditions" (HACs) from its comparison site last summer, but did keep it on a public spreadsheet accessible to researchers, patient-safety advocates and consumers who could translate it. But as of last month, that public spreadsheet is gone, leaving researchers to calculate their own rates using claims data.
Prior to the removal, the Hospital Compare website listed how frequent HACs occurred at numerous acute care hospitals - medical facilities where patients stay up to 25 days for severe injuries, illnesses, or while recovering from surgery - in the U.S. Now, CMS is only reporting the rate of occurrence for 13 conditions like MRSA and sepsis infections after surgery, but are dropping others.
CMS told USA Today some of the new data includes different, more reliable measurements of the same condition, like the use of Centers for Disease Control and Prevention data on bloodstream infections.
In an e-mail to USA Today, spokesman Aaron Albright said CMS changed what it reported to make things "more comprehensive and most relevant to consumers." Albright also said the new measures received "strong support" from a partnership of the National Quality Forum, which reviews performance measures that might be used in federal or private reporting and payment programs. According to Albright, CMS prefers to use NQF-endorsed measures because they "offer a rigorous and thorough review process."
But Helen Haskell, a patient-safety advocate, told USA Today she believes some members of the hospital working group she was in thought they were voting to strengthen the measures, not drop them.
"When we voted, I certainly didn't think it would result in the (hospital acquired conditions) being removed from Hospital Compare," Haskell, whose son died in 2000 of a reaction to medication after surgery, told USA Today.
NQF spokeswoman Ann Grenier told USA Today the panel decided the data should be removed because it wasn't "appropriate for comparing one hospital to another." According to Grenier, a majority of the quality forum's members represent consumers, insurers and others who buy health care. However she does acknowledge those who don't work in the field full-time could find the process confusing.
The Affordable Care Act mandates that the 25 percent of hospitals with the highest rates of certain types of HACs, including hip fractures or sepsis after surgery, receive up to 1 percent less in Medicare reimbursement, USA Today reports. And additional Medicare or Medicaid reimbursement is withheld if treatment is related to one of the eight HACs.
Although the data is considered reliable enough to penalize hospitals, CMS and the American Hospital Association question the reliability of the data on mistakes, including foreign objects left behind after surgery.
CMS said it is working on new ways of measuring HACs that will represent some of the most common unfortunate events in hospitals and that the HACs that are not publicly available anymore are considered rare events that should never happen in hospitals. However, USA Today notes that that should make them harder to track and more important for consumers to know about.
USA Today reported in March that foreign objects may be retained after surgery twice as often as the government estimates. That number is about 6,000 times a year. Sponges account for more than two-thirds of all incidents and can ultimately embed in a person's intestines, USA Today stated.
Nancy Foster, quality and patient-safety vice president for the American Hospital Association, told USA Today that the reporting of information and mistakes has to be reliable or it doesn't benefit hospitals or consumers and "defeats the purpose of being transparent."
But other experts say consumers do have a right to the information.
Leah Binder, CEO of the Leapfrog Group which issues hospital safety ratings, told USA Today, "People deserve to know if the hospital down the street from them had a disastrous event and should be able to judge for themselves whether that's reasonable indicator of the safety of that hospital."
