Report card ranks Ontario hospitals

Among hospitals in large Ontario cities, those in Hamiltonrank the highest in patient safety and quality of care, while those in Toronto are the lowest,according to areport card released Tuesday on acute care hospitals in the province.

The reportby the Fraser Institute reviewed death rates, side-effects such as surgical complications, volume and usage rates for hospital procedures,medical conditionsand childbirth. It usedanonymous patient data from the Canadian Institute for Health Information.

"This constitutes the most comprehensive measure of acute care hospital performance and accountability in Canada available at the present time," said Mark Mullins, co-author of the report and executive director of the Fraser Institute, aright-leaning think-tank that adopted indicators developed by the U.S. Agency for Healthcare Research and Quality to assess all acute care hospitals in Ontario.

Acute care hospitals offer surgical, psychiatric and obstetricservices. The report includes information for all 136 acute care hospital in Ontario. Of these, 43 agreed to be named, while the others are indicated by a number. The bottom 10 were not named.

The report includes a hospital mortality index or summary of mortality rates for various conditions, such as deaths because of hip replacement surgery, heart attacks and pneumonia. The report's authors said they adjustedresults for how specialized hospitals may treat more high-risk patients.

The report card aims to "help people make informed choices about their health care," Mullins said, but he does not recommend anyone choose a hospital based solely on the statistics.

'Fundamentally flawed'

Dr. Isser Dubinsky, a former Toronto emergency room physician and associate director with Hay Group Health Care Consulting, questioned the approach used by the Fraser Institute.

"I think the conceptual notion of trying to rank hospitals to provide better information both to care providers and consumers is an important concept, but the approach that the Fraser Institute has used in this particular case is fairly fundamentally flawed and can't be relied upon either by caregivers or consumers."

Increasingly high-quality, objective information will be made public on wait times for cancer care in the province, Dubinksy noted.

In the meantime, he suggested patients and their families rely on the guidance of their family physicians and question specialists about death rates, complication rates, how long patients stay in hospital and what alternative therapies are available to make an informed decision about their care.

Overall, Arnprior in eastern Ontariohad the lowest hospital death rates in the Fraser Institute report. Itearneda high score of 79.8 out of 100 on the hospital mortality index. Arnprior andsecond-ranked Maple had inadequate data for the late1990s, the report noted.

Of the five largest municipalities in Ontario, Hamiltonhad the highest ranking, while Toronto had the lowest. Hamilton ranked22nd out of 105 municipalities over the past three years, with a score of 73.7. Toronto was 39th, with a score of 72.1.

Ottawa ranked 33rd with a score of 72.8, Mississauga ranked 29th with a score of 73.1 and Scarborough ranked 57th with a score of 69.7.

Forhospitals, the hospital mortality index says the William Osler Health Centre in Brampton had the third-highest ratingover the past three years, with two anonymous hospitals ranked first and second.