Dec 3, 2018

The poor state of U.S. hospital quality

A doctor prepares for surgery in a hospital operating room. Photo: Andrew Lichtenstein/Corbis via Getty Images

A slew of recent incidents and investigations offer a stark reminder that the U.S. health care system — and hospital care in particular — struggles with serious shortcomings in quality, even though we spent $3.5 trillion on health care in 2017.

The bottom line: "We are unnecessarily killing thousands of people every year because hospital quality is not what it should be," said Leah Binder, CEO of The Leapfrog Group, an organization that grades hospital care. 

Driving the news:

  • A WebMD/Georgia Health News investigation found a third of the country's hospitals have violated basic federal rules for providing emergency care.
  • Baylor St. Luke's Medical Center is now drawing scrutiny for poor outcomes with its liver and lung transplants, after ProPublica and the Houston Chronicle highlighted failures with heart transplants.
  • Kids at the Johns Hopkins children's hospital in Florida are dying "at an alarming rate," the Tampa Bay Times recently reported.
  • The federal government is threatening to end Medicare and Medicaid funding at Vanderbilt University Medical Center after a patient died from getting the wrong medication.
  • A large Detroit hospital faces the same threat due to dirty surgical equipment.
  • Psychiatric hospitals and drug treatment facilities have become notorious for poor care.
  • The federal government routinely settles hospital cases, often under the radar, over instances of shoddy care. For example, earlier this year, a hospital in North Carolina was fined for not properly treating and following up on an ER patient who said he had suicidal thoughts — and that patient later shot himself in the head.

The big picture: There are some relatively easy things the federal government could do to increase transparency. For example, the Centers for Disease Control and Prevention collects data on hospital infection rates, but the public can't search that data for specific hospitals. The feds could also force hospitals to release accreditation reports.

Patients, meanwhile, are left to rely on often conflicting or confusing information about a hospital's quality.

  • "There's lots of ratings that will say, 'This is the No. 1 hospital, this is the great hospital list.' But what we also need are ratings on where not to go," Binder said. "But there's some risk to exposing and embarrassing any part of that."

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