The Fraser Institute's Hospital Report Card: British
Columbia 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 British
Columbia. All of the information in this report is available at
our
interactive web site
.
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 British Columbia. 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 the CIHI by all hospitals in British Columbia. Demographic,
administrative, and clinical data are extracted from the
Discharge Abstract Database for inpatient hospital stays from all
acute-care hospitals in British Columbia. 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 the indicators for patients with the same condition
but a different health status. The international standard for
risk adjustment, 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.