Traverse City Record-Eagle

August 8, 2013

Mixed diagnosis for Munson

Traverse City Record-Eagle

---- — TRAVERSE CITY — The most recent issue of Consumer Reports gave Munson Medical Center its lowest rating for surgery, based on the percentage of people who died in the hospital or stayed longer than expected for a given procedure.

Only four hospitals of 29 in Michigan earned the magazine’s “worst” rating.

Yet Consumer Reports also gave Munson Medical Center a first place ranking in the state for patient safety in its May issue. Its ranking was based on infection, re-admission, complication and adverse effects data.

Consumer Reports used length of hospital stay in its ranking because research shows a correlation with complications. But there are two sides to the coin, said David McGreaham, a physician and Munson’s vice president of medical affairs.

“You don’t want to get people out of the hospital before they are ready,” McGreaham said. “But you don’t want to stay in the hospital because it’s a very dangerous place to be with the potential for infections, and it’s very expensive. We’re trying to walk that line and get people out at an appropriate time. We looked at benchmark data, and we do have opportunities in certain areas.”

Munson has “challenges” with longer patient stays because it serves a large rural area and deals with transportation and follow-up issues, he said.

Consumers Report also used patient mortality as a measure. Munson looked at its benchmarks and is at or below expected number of deaths, McGreaham said.

“It’s very confusing. If we look at surgical complications, we’re better than expected in the Medicare database,” he said.

Consumers Report based its ranking on billing claims submitted to Medicare from 2009 to 2011 for patients 65 and older for 27 types of surgeries.

In a supplementary report, Munson received the “worst” rating for knee and hip replacements. It received top scores for pain control and patient communication with nurses and doctors.

McGreaham said Munson closely tracks medical databases and tries to learn from them. On the other hand, he sees an increasing number of hospital quality rankings, all based on different databases.

“We need to come together and develop a database for consumers that everyone can understand that are based on metrics that are validated,” he said.

This is Consumers Reports’ first effort to compare how surgical patients fare in 2,400 U.S. hospitals. The magazine conceded in a press release that it used the best data available, but could have used more comprehensive, standardized data.

“We know the ratings aren’t a perfect measurement but we think they’re an important first step in giving patients the information they need to make an informed choice,” said John Santa, medical director of Consumer Reports Health.

Munson frequently has ranked as a “Top 100 Hospital” over two decades, but consumers don’t have access to the report’s detailed findings. This year, Munson didn’t make it into the Top 100; the president of Munson Medical Center cited length of patient stay as a factor.

McGreaham agreed with Consumers Report that patients would be wise to research their medical options. He recommended checking out a surgeon’s reputation and depth of experience, along with talking to their physician. A hospital’s reputation also comes into play if a type of surgery is rarely done there.

“That makes it a little riskier,” he said.

He also believes Munson needs to play a role by providing transparent medical data.

“We’re moving in that direction, and we’re not quite there yet,” he said.