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Fraser Institute Launches Report Card on Ontario's Acute Care Hospitals

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Release Date: September 5, 2006
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 Fraser Institute's 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 report.