The Fraser Institute’s Hospital Report Card: British Columbia 2011 is constructed in order to contribute to the improvement of inpatient care in British Columbia by providing hospital-specific information about quality of service directly to patients and to the general public. It aims to promote greater accountability within hospitals, thereby stimulating improved performance through independent and objective measurement.
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. The report card uses the Discharge Abstract Database (DAD) of the Canadian Institute for Health Information (CIHI) as its primary information source, employs the 3M™ APR™-DRG Classification System to risk-adjust the data (ie., adjust rates for patients with the same condition but a different health status), and consists of 39 indicators of inpatient quality (such as death due to a stroke) and patient safety (such as a foreign body left inside a patient during a procedure) developed by the US Agency for Healthcare Research and Quality (AHRQ) in conjunction with Stanford University. This latest edition of the Hospital Report Card: British Columbia also includes two experimental indicators adapted by the Fraser Institute that attempt to capture the potentially distinct circumstances of care provision in British Columbia.
The Fraser Institute spent two years developing the methods, databases, and computer programs required to adapt the AHRQ 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.