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Hospital Report Card: Alberta 2009

Type: Research Studies
Date Published: June 18, 2009
Authors:
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Hospital Report Cards

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.

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.

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