The Fraser Institute today launched the
Hospital Report Card: Ontario 2006
, a new report and interactive web site that assesses 50 measures of patient safety and quality of care for every acute care
hospital in Ontario. The Report Card's interactive web site can be found at
"The goal of this new
Hospital Report Card
is to contribute to the improvement of hospital care by providing
quality of care information directly to patients and the general
public. This will help people make informed choices about their
health care and improve hospital performance through enhanced
transparency and accountability," said Mark Mullins, co-author
and Executive Director of The Fraser Institute.
Information is shown for all of the 136 acute care hospitals in
Ontario from fiscal year 1997 to 2005, comprising more than 8.5
million patient records. The report also calculates the 50
indicators for all of the 138 municipalities in Ontario, based on
patient location. Forty-three hospitals agreed to have their
institutions identified by name in this
Hospital Report Card
. Other hospitals are anonymously shown in the report by number.
"This constitutes the most comprehensive measure of acute care
hospital performance and accountability in Canada available at
the present time," said Mullins.
Among the 50 measures are death rates, adverse events, volumes
and usage rates in three categories: hospital procedures, medical
conditions and those related to child birth. A Hospital Mortality
Index is calculated as a summary measure of mortality rates in
the larger hospitals (where adequate data are available).
The Hospital Mortality Index assessment reveals that William
Osler Health Centre in Brampton is the third top-ranked hospital
over the past three years, while two anonymous hospitals are
ranked first and second. Interestingly, all of the ten
bottom-ranked hospitals over the past three years are anonymous.
Stratford General Hospital, Ottawa Hospital (General Site) and
Timmons and District General Hospital have all had consistently
strong Hospital Mortality Index scores over the study period from
1997 to 2005.
The three top-ranked municipalities over the past three years
(based on patient location information) are Arnprior, Maple and
Stratford. Of the five largest municipalities in Ontario,
Hamilton is the highest ranked at 22nd out of 105 municipalities
over the past three years, and Toronto is the lowest ranked at
39th out of 105 municipalities.
"For the first time in Ontario and in Canada, patients and the
general public will be able to assess the quality of care
delivered by their local hospital in a detailed manner," said
Mullins. "This is a momentous occasion. Therefore, we
congratulate the forty-three hospitals that opted to participate
in the study and look forward to a more informed discussion on
the state of hospital care in this country."
Important Note on Methodology
The report uses a state-of-the-art indicator methodology,
developed by the U.S. Agency for Healthcare Research and Quality
(AHRQ) in conjunction with Stanford University, that has been
shown to reflect quality of care inside hospitals.
These indicators are presently in use in a dozen U.S. states,
including New York, Texas, Florida and California. In Canada, the
Manitoba Center for Health Policy released a report in June 2006
using the AHRQ patient safety indicators. In addition, the OECD
recommends this approach by noting that "this set of measures
represents an exciting development and their use should be tested
in a variety of countries."
The report is based on anonymous patient-level data purchased
from the Canadian Institute for Health Information (CIHI). These
data are used to produce various CIHI reports and indicators,
including annual reports on the performance of the health care
system and seven of the health indicators adopted by the federal,
provincial and territorial governments. The Ontario Hospital
Association, in affiliation with CIHI and the Government of
Ontario, uses the same patient information that underlies the
Hospital Report Card
in its acute care hospital report.
It is important to note that the 50 indicators and the Hospital
Mortality Index are applicable only to acute care conditions and
procedures for inpatient care. The results cannot be generalized
to assessing the overall performance of any given hospital. It is
also not recommended to choose a hospital based solely on
statistics and descriptions such as those given in this