The Fraser Institute's
Hospital Report Card Alberta 2009
is constructed to help patients choose the best hospital for
their inpatient care by providing them with information on the
performance of acute-care hospitals in Alberta. All of the
information in this report is available at our interactive
website,
http://www.hospitalreportcards.ca/ab/
.
We set out to create a hospital report card that is easy to
understand and accessible by the public, where individuals are
able to look up a given condition or procedure and compare
death rates, volumes of procedures, rates of adverse events,
and utilization rates for their hospital to those of other
hospitals in Alberta. This is accomplished by using
state-of-the-art indicators developed by the US Agency for
Healthcare Research and Quality (AHRQ) in conjunction with
Stanford University that have been shown to reflect quality of
care inside hospitals. These indicators are presently in use in
more than a dozen US states, including several of the more
populous ones, New York, Texas, Florida, and California.
We are using the Canadian Institute for Health Information's
(CIHI) Discharge Abstract Database (DAD) as our primary
information source. This information is derived from patient
records provided to CIHI by all hospitals in Alberta.
Demographic, administrative, and clinical data are extracted
from the Discharge Abstract Database for inpatient hospital
stays for all acute-care hospitals in Alberta. Since more
specialized hospitals may treat more high-risk patients and
some patients arrive at hospitals sicker than others, it is
important to risk-adjust hospital death rates, adverse events
rates, and utilization rates for patients with the same
condition but a different health status. The international
standard for risk adjustment, the the 3M™ APR™-DRG
Classification System, is employed to risk-adjust the data. The
Fraser Institute spent two years developing the methods,
databases, and computer programs required to adapt the measures
to Canadian circumstances. This work has been internally and
externally peer-reviewed (Mullins, Menaker, and Esmail, 2006)
and is supported by an extensive body of research based on the
AHRQ approach.
None of Alberta's 102 acute-care hospitals are identified by
name in this report. This contrasts with the Fraser Institute's
recently released
Hospital Report Card: British Columbia 2009
, in which, resulting from a decision made by the Minister of
Health, all of British Columbia's 95 hospitals were identified.
By not allowing hospitals to be identified in the Report,
Alberta Health Services has restricted the ability of patients
in Alberta to assess the health care they receive.