Oct. 26--TAMPA -- As they look for ways to rein in health care spending, Medicare officials are turning to patient safety as a way to judge which hospitals are worth the money.
Starting next October, hospitals with above-average rates of patients with surgical complications and post-operation complications, such as breathing problems or blood clots, could lose as much as 2 percent of their Medicare funding.
That's raising concerns at Tampa General Hospital, which ranks at the bottom of the Tampa Bay region's 30 hospitals, compared to national standards of patient safety.
Those measures are spelled out in Hospital Compare, an online database federal officials launched this month.
The database was designed to let consumers compare hospitals to one another and against national averages on a variety of issues, from post-surgical complications to how well hospital staffers treat their patients.
People who look up Largo Medical Center, for example, will find that patients are less likely to die from breathing problems after surgery than the national average. The hospital is about average for the number of patients who develop blood clots after surgery.
At Morton Plant Hospital in Clearwater, 64 percent of patients said they'd recommend the hospital to someone else -- a rate that's about 10 percent below the national average.
The Medicare database provides health-care consumers with valuable information that can help them make important decisions, said Bill Newton, executive director of Tampa-based Florida Consumer Action Network.
"We want patients to have information. They need the feedback," he said. "The good think is the government is a neutral source."
The Hospital Compare database grew out of last year's Affordable Care Act, which includes a raft of efforts aimed at reducing health care costs.
Among other things, Medicare officials are considering ways to curb expenses related to terminal patients' final days and to get hospitals to reduce their readmissions related to heart disease and other chronic conditions.
TGH officials say Hospital Compare gives the region's biggest hospital short shrift.
Their patients are often poorer and sicker than those at other hospitals, making them more prone to hospital-acquired infections, surgical complications and other problems. Larger hospitals such as TGH also end up caring for patients with issues that are too complex for smaller hospitals.
"We rank very high on how sick our patients are," said Dr. Sally Houston, TGH's chief medical officer.
TGH isn't alone in posting poor scores on Hospital Compare.
In all, eight of the region's hospitals fall below average in at least one Medicare measure. Four rank above average.
Statewide, Florida's teaching hospitals -- a list that includes TGH, Jackson Memorial in Miami and Shands Jacksonville Medical Center in Duval County -- all rank low on Hospital Compare largely because of their patient demographics, said Atul Grover, a spokesman for the Association of American Medical Colleges.
Teaching hospitals have the specialized staff and high-tech equipment needed to care for very sick people. But that affects the hospitals' standings in the Hospital Compare rankings.
The state's nonteaching hospitals tend to rank at or above national averages for most patient-safety measures reported in the database.
The government's ranking system favors smaller, wealthier hospitals, according to Houston and Grover. Those hospitals often transfer their most serious cases to bigger facilities, such as TGH. It's also easier to bring a smaller staff in line with changing rules than one with 1,100 doctors, Houston said.
The foundation of Medicare's comparisons -- billing records -- provide a cut-and-dried way to measure hospital activities, but aren't as accurate as other ways of checking hospital performance, industry officials say.
"If members of the public are making key decisions about where they want to go for their hospitalization based on this data, they could be misled," said Nancy Foster, vice president for quality at the American Hospital Association, an industry trade group.
TGH's recent switch to all-electronic medical records -- another mandate of the Affordable Care Act -- will standardize the way doctors report the kinds of problems tracked by the Hospital Care database, Houston said. That should improve TGH's performance, she said.
"The thing that's frustrating to us is that while we start seeing improvements in next few months, it won't be reflected on the site for a year," Houston said. "So we'll just have to take our lumps right now."
To check on your hospital, go to www.hospitalcompare.hhs.gov.
kwiatrowski@tampatrib.com (813) 259-7871 Twitter: TBOKevinW
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