Do Ontarians want to choose from rated health care providers, or do they want uniform quality standards?

“[My wife] Debbie and I can visit a city and see how restaurants and hotels are rated, but there’s nothing like that for our healthcare system. If my mom gets her knees done, I want to make sure she knows she can get that done where she can get the best possible results and they treat the patient well throughout their entire experience.” – PC Leader Tim Hudak.

Where has Tim Hudak been? Ranking the performance of the health system has become a sizeable activity in this province. Much of it is as limited in value as the hotel and restaurant rankings he and his wife appreciate.

Not all of it is in the public sector. For example, many private-sector sites exist that ask users to do the rating. For example:  http://www.ratemds.com/ allows patients to trash or praise their doctor. Of course, none of this information is verified or subject to professional review. Want to find a quality nursing home? Similarily you can always try http://www.nursinghomeratings.ca/understand-the-nursing-home-system/ontario

Public bodies also provide information rating health care providers.

Wait times are kept on a central web site at http://www.health.gov.on.ca/en/public/programs/waittimes/

Health Quality Ontario issues annual reports on the performance of the system at http://www.ohqc.ca/en/index.php

Each individual hospital posts a performance scorecard on-line, although many people may have problems understanding the methodology and terms on these sites.

And there is an Ontario Hospital Association site that allows you to compare your hospital’s performance against the average. See http://www.myhospitalcare.ca/Pages/homepage.aspx

Looking for a long term care home? The government maintains a site with inspection reports at http://publicreporting.ltchomes.net/en-ca/default.aspx

Like those hotel and restaurant ratings he and his wife enjoy accessing, all this health care data can be suspect, incomplete, and lacking timeliness. Is it really helpful to know what a specific hospital’s C-Difficile rate is if the data is eight months old?

Peterborough Regional Hospital recently posted a negative standardized hospital mortality ratio score (HSMR). The HSMR is a ratio of a hospital’s rate of unexpected deaths to a national average, adjusted for age, sex and diagnoses of patients. It appears Peterborough’s method of fixing the score is not to improve care at the hospital, but to change the way hospital deaths are recorded. Under such circumstances, what is the real value of such data?

Also, the more health care is pushed into the private sector –as is Hudak’s pledge – the more difficult this information is to obtain.  Corporations frequently claim information is proprietary if they don’t want to release it to the public.

Hudak recently complained that health professionals were spending too much time on paperwork. If he expects greater reporting, this would require more paperwork, not less.

In a recent Vector poll the public liked the ability to look up quality performance information, but overwhelmingly said that it was up to government to provide oversight and maintain quality standards.

Instead of picking and choosing based on dubious quality reports, shouldn’t the government’s objective be to provide consistent high-quality care regardless of where it is located?

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