WASHINGTON – Maryland hospitals almost always administered aspirin and beta blockers when heart attack patients came in and when they left, but the hospitals were less consistent when it came to administering recommended medications.
Those were the findings of a report released Thursday by the Maryland Health Care Commission, which also found that hospitals fell short when it came to counseling heart attack patients on ways to stop smoking.
The commission began posting data on all 47 Maryland hospitals on the Internet in 2002, listing everything from the number of beds to the presence of midwives, but the new data is the first to measure hospital performance with heart attack patients.
The goal is to better inform patients about their care and to encourage hospitals to improve their performance.
“I think that one of the things we try to do with our site is to provide education,” said Jean Moody-Williams, the commission’s facility quality and performance chief. “Data in and of itself isn’t going to help anybody unless they know what to do with it.”
Moody-Williams said the information posted by the commission was not previously available to the public, which was not empowered to make informed decisions in health care.
But with “an increasing expectation that consumers participate,” thanks to increasing premiums and higher deductibles, consumers want more choices and information about the care they receive, she said.
“The Internet generation expects information about their healthcare,” Moody-Williams said.
State hospital officials said they welcome the expansion of available public information about healthcare. A spokeswoman for the Maryland Hospital Association said the commission’s Maryland Hospital Performance Evaluation Guide is nice because it “provides both consumers and providers information on how to improve.”
“The guide is a tool, one tool, one of many, and what it does is provide the consumer with some additional information which then can be the basis of asking good questions of hospitals and doctors,” said Nancy Fiedler, the association spokeswoman.
The guide’s new information on the quality of heart attack care in 2004 was released Thursday. It reported that out of all the heart attack patients who should have received aspirin upon arrival, 94 percent did, and 87 percent got beta blockers, which relax the blood vessels around the heart and therefore decrease the heart’s work.
The guide said that heart attack patients who needed beta blockers or aspirin upon departure got them 89 percent of the time.
The performance took a downward turn, however, when it came to providing patients with the recommended medications: Only 73 percent of patients who needed medication got the suggested medicine. And state hospitals counseled smokers on how to quit just 75 percent of the time.
Fiedler said hospitals might actually be doing a better job of counseling patients on how to stop smoking. She said it is possible that a nurse or physician might educate a patient on how to quit smoking without noting that fact on the medical chart, which is where this information comes from.
But both she and Moody-Williams said the data is valuable and consumers should take advantage of it.
Besides helping locate hospitals for newcomers, Moody-Williams said patients can use the site to compare hospitals in their area. It can provide basic information about the hospitals as well as statistics on how often and how well they treat a specific condition.
Even for those whose hospital choices are limited by their location or their insurance coverage, Moody-Williams said the site will tell them what service to expect and will suggest how they can deal with sub-standard practices.
And more is on the way, she said.
“We’re planning to add patient satisfaction reports on facilities by the end of the year, hopefully,” she said. “We want to add surgical infection prevention measures.”
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