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Dr. John Santa


Reducing adverse events in scheduled surgery


On July 31, we released ratings of 2,463 hospitals for common scheduled surgeries in Consumer Reports magazine and at

We worked with a well-established data partner, MPA, a company with decades of experience in analysis and research of large health databases. The Ratings are based on an analysis of Medicare billing data. The data has undergone extensive "scrubbing," risk adjustment, and other adjustments to improve its accuracy. The data focuses on death and prolonged length of stay for each hospital.


While factors other than complications can contribute to extended hospital stays, research has shown that hospital-acquired complications correlate with death and length of stay. There is more direct data in medical records or special reports but this kind of information is not usually made public. We include an overall Rating for a hospital and Ratings for five very common surgeries including hip replacement, knee replacement, angioplasty, carotid artery surgery (the major vessel to your brain in your neck) and back surgery.


Some well-known hospitals do not do well. Overall, teaching hospitals for example do no better than other hospitals. There are some notable performers who do not do well--Massachusetts General in Boston, Hospital for Special Surgery in NYC, and Washington DC where 4 of the 5 hospitals with sufficient data are poor performers (including George Washington University) and the fifth is average.


There are lots of good performers--including three New York City hospitals--NYU Langone, Mt Sinai and NY Presbyterian. Some western states like Washington, Minnesota and Wisconsin have several good performers and only a few poor performers. On the other hand Alabama, Mississippi and Puerto Rico have no good performers and many poor performers.


We acknowledge that analyzing billing data has limitations but feel we and MPA have taken many steps to focus the analysis in credible ways. We assert that it is time for consumers to have access to data like this and if hospitals have better data they should release it to the public. There is very good evidence that there are several interventions which can improve surgical adverse events.


As part of our process we have had several experts in the field review the methodology, interviewed proponents and opponents and included comments from each in the article (including representatives from low-performing hospitals), provided the methodology to hospitals six days before the release and conducted an audio presentation explaining the methodology.


You can read the full story and see the Ratings online now


John Santa, M.D

Director, Consumer Reports Health Ratings Center

August 2013 Newsletter
In this Issue
What's New
Partner Update
Campaign Update
Support Our Work
Quick Links

What's New

Our redesigned website 


It's a good problem to have: So many new resources and so many new visitors,

that your website design can't cope.


That's why we've re-launched help everyone

quickly find the information they're after.


The new design sorts the site into three clear paths. One is for our campaign

partners and others with questions about our several campaigns. The second

is for health professionals who are looking for consumer health education materials

to distribute. The third is for consumers and patients, who typically arrive at the

site with particular questions and concerns in mind. The navigation and highlights

are different for each path.


Underlying all three paths is a powerful new catalog. It features expanded

descriptions of each item. And now anyone can create a customized display

of our brochures, videos and campaign support materials. We add new materials

every week.


As before, site visitors also can keep up with overall work of the Health Ratings

Center, learn about our many partners and be kept abreast of the latest news

about Choosing Wisely and other efforts.


If you haven't visited in a while, take a look!


Partner Update

Our Notes from the April Patient Empowerment Expo


In mid-April, The American College of Physicians and Consumer Reports

co-sponsored Your Health: Fact Not Fiction. A Patient Empowerment Expo 

in San Francisco. The 3-hour conference was free and open to the public,

and focused on empowering consumers to take control of their healthcare

by learning how to talk to their doctors and knowing what questions to ask.

The presentations with doctors included such topics as the best and worst

screening tests, which medical tests are needed and which are not, and how

to live a healthy life. It was a pleasure to get together with more than 300

who listened to terrific advice from Dr. John Whyte of the Discovery Channel, 

Dr. Daisy Smith and Dr. Doug Paauw, and had the opportunity to ask and have

answered many of their own questions. As a thank you to those consumers who

registered and attended this empowering event, we pulled together the key

points from all of the presentations and created a handy summary as a reminder

of the great advice that was shared at the expo. You can view that by clicking here.

We hope you will take a look, find it useful, and share it with others. 


Campaign Update

Choosing Wisely Outreach Efforts 


Consumer Reports continues to collaborate with 21 Choosing Wisely grantees--state

medical societies, specialty societies and regional health collaboratives, all of which

received a grant from the ABIM Foundation with support from the Robert Wood Johnson Foundation--to educate consumers about overly used and prescribed medical tests and procedures. In just the past three months, grantees have achieved many accomplishments, including creating an app (American Society of Echocardiography), hosting a consumer

focused webinar (Maine Quality Counts), receiving an award for "excellence in patient and physician outreach" (Washington State Medical Association), and publishing a front page

article in Tennessee Medicine (Tennessee Medical Association).



To support the grantees, Consumer Reports continues to create brochures on overly

used and prescribed medical tests and procedures. In the past three months alone,

we've published 17 more, with topics ranging from Lyme Disease Testing to Medical

Tests before Eye Surgery to Alzheimer 's disease Testing.


We've also produced three new videos, and in response to grantees requesting posters

to hang in clinics and hospitals and share with employer groups, we updated our poster

called "5 Questions to Ask Your Doctor before You Get Any Test, Treatment, or Procedure"

and its corresponding wallet card.


Support Our Work

Consumer Education and Outreach


Since 2012 Consumer Reports has invested in the development and distribution 

of FREE educational materials to support the Choosing WiselyŽ campaign. Through 

our efforts, we've built a network of partners to communicate with consumers about 

appropriate use of medical tests, treatments and procedures and educate them on 

the need for better communication with their doctors. In less than a year, we collaborated 

with more than nine medical specialty societies to publish dozens of consumer pamphlets 

and videos, in English and Spanish to spread the message. These communication activities 

had the potential to reach tens of millions of consumers.

In February 2013, the number of medical specialty societies taking part in the 

Choosing Wisely campaign expanded from nine to over 25. Now, Consumer Reports 

is seeking help to sustain, improve and grow our communications efforts through at 

least March 2015 and introduce new and more innovative approaches to our existing 

consumer communications efforts.

Consumer Reports is an expert, independent, nonprofit organization. We do not accept 

advertising or corporate support of any kind. By making a tax-deductible donation in 

general support of this consumer campaign you will be providing support to a project 

that will empower consumers to make better health decisions and help them lead healthier 

lives. Donate today.


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