TORONTO, ON-The majority of hospitals in Ontario refuse to
be identified in a report measuring the quality and safety of
hospital care, leaving Ontario taxpayers and patients with no
way of knowing if their local hospital is one of the best in
the province, or one of the worst.
The Fraser Institute today released the
Hospital Report Card: Ontario 2009, a peer-reviewed and risk-adjusted study that compares the performance of Ontario's 136 acute care hospitals. Only 17
hospitals agreed to be named in this year's report, a
significant drop from the first report card for Ontario in 2006
when 43 hospitals agreed to be identified.
"By refusing to be identified, Ontario hospital
administrators are hiding vital information from Ontario
taxpayers and patients about the quality of tax-funded health
care provided in their community," said Nadeem Esmail, director
of health system performance studies at the Fraser Institute
and co-author of the Hospital Report Card: Ontario 2009.
"While the hospitals that agreed to be identified in this
report should be applauded for their commitment to patients and
the public by being accountable and transparent regarding their
performance, administrators who refuse to be identified are
ducking accountability and hiding behind a wall of
The hospital report card can also be viewed in an
interactive way at www.hospitalreportcards.ca
The peer-reviewed Hospital Report Card: Ontario 2009
compares the performance of hospitals on up to 50 separate
indicators of quality (such as death due to a stroke) and
patient safety (such as a foreign body left inside a patient
during a procedure). The methodology was developed by the US
Agency for Healthcare Research and Quality (AHRQ) and
researchers at Stanford University and employs a
risk-adjustment system developed by 3M. The AHRQ methodology is
used in more than a dozen U.S. states as well as British
Columbia and Ontario. The current report card provides 39
indicators of inpatient quality and patient safety calculated
for the latest year for which results are available as well as
a Hospital Mortality Index that shows overall performance
across nine indicators of mortality. The indicators are shown
for acute-care hospitals in Ontario from 1997/98 to 2006/07
(where available), comprising more than 10.5 million completely
anonymous patient records.
Since specialized hospitals may treat more high-risk
patients and some patients arrive at hospitals sicker than
others, the indicators in the Fraser Institute's hospital
report card are risk-adjusted to account for differences in
health status among patients.
The report card is based on data from the Canadian Institute
for Health Information's (CIHI) Discharge Abstract Database.
This information is derived from patient records provided to
CIHI by all Ontario hospitals.
Hospital Report Card: Ontario 2009
allows the public to look up a given condition or procedure and
compare death rates, volumes of procedures, rates of adverse
events, or utilization rates among Ontario's hospitals.
"If you have a greater chance of dying from a heart attack
in one hospital compared to another, or if there was a greater
chance of having a foreign object left inside of you following
surgery, isn't that something you would want to know? Patients
have a right to know how their hospital compares to other
hospitals," Esmail said.
Hospital Report Card: Ontario 2009
- The top hospital on the Hospital Mortality Index (HMI) in
Ontario is Anonymous Hospital 211 with a score of 91.1 out of
100 in 2006/07. It was not among the top 10 in 2005/06;
- Anonymous Hospital 10 was ranked first on the HMI in
2005/06 and ranks seventh in 2006/07;
- Anonymous Hospital 31 is the lowest-ranked hospital in
2006/07 with a score of 78.3. It saw a deterioration in its
score between 2005/06 and 2006/07 and was ranked 52nd out of
57 in 2005/06;
- Anonymous Hospital 40 experienced the biggest improvement
in its HMI from 2005/06 among hospitals for which an HMI
could be calculated in both years. It went from 56th out of
57 in 2005/06 to 47th of 59 in 2006/07;
- Rouge Valley Health System - Ajax and Pickering Site at
32nd is the highest ranked identified hospital on the HMI
with a score of 86.7; and
- Bluewater Health - Sarnia General Site is the
lowest-ranked participating hospital, ranked 58th of 59 with
a score of 79.9.
The report card also provides information on the various
indicators of inpatient quality and patient safety for
municipalities (based on where patients lived).
Looking at the Hospital Mortality Index, Caledon had the
highest ranking, at 93.1. Innisfil is second at 90.0 followed
by Essex at 89.5. Among the larger municipalities, Thunder Bay
is ranked fourth at 88.9; Brampton is sixth at 88.6; Hamilton
is 12th at 86.8; Ottawa 22nd at 85.2; Toronto 28th at 84.7;
North York 32nd at 84.5; Mississauga 36th at 84.1; Sudbury 45th
at 83.1; Windsor 49th at 82.8; Kingston 66th at 80.9; and
Kitchener 71st at 80.4.
The lowest ranked municipality is Kirkland Lake at 58.6,
followed by Meaford at 62.0, and Napanee at 66.6.
However, Esmail cautioned that since patients move between
municipalities, a municipality's ranking does not equate to the
ranking of its hospital. This means the highest or lowest
performing municipality is not necessarily home to the best or
worst performing hospital.