'Expert' thinking on hospital ranking

The Ontario government is considering a ranking system that would award Ontario hospitals stars for good performance, while identifying poor performers, the Ottawa Citizen claims. The “name-and-shame” scheme would be modeled after a short-lived British experiment.

'Under the proposed system, hospitals would be given a rating of as many as three stars for their performance in areas such as treating patients safely and effectively, reducing surgical and emergency-room waits and improving cleanliness. Another system under consideration would simply rate hospitals “excellent,” “good,” “fair” or “weak,” according to documents released to the Citizen under provincial freedom-of-information laws.

'The merits and pitfalls of a star-rating system were discussed in 2009 by a panel of 13 experts advising Health Minister Deb Matthews on the future financing and accountability of hospitals. However, it’s not clear if the government has adopted the idea.'

The Citizen adds a ranking system "could also lay the groundwork for more sweeping changes to how hospitals are funded, with the goal of rewarding those that are more efficient and treat patients safely and effectively."

The Citizen says some British hospitals manipulated their data to look like they had improved standards when they actually hadn’t. For example, to meet the target of a maximum four-hour wait for treatment in emergency departments, some hospitals made patients wait in ambulances outside the hospital until staff were confident they could be treated.

While details on the proposal are just emerging, this appears to be one more step towards a system based on competition and fragmentation rather than cooperation and integration. The actual "choice" it will provide is limited for most, who will continue to rely on their doctors' advice and who, in any case, often live in cities with only one hospital.

The influence of British health care experiments on the thinking at the Ministry of Health and Long Term Care continues. And that is a scary thought, given what the British Conservative-Liberal government is up to.

Comments

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data. This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization. Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion. That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year. The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million. In total, there were 60,653 COVID hospitalizations in Ontario in 2022/3, up from 47,543 in 2021/2.

More spending on new hospitals and new beds? Nope

Hospital funding: There is something off about the provincial government's Budget claims on hospital capital funding (funding to build and renovate hospital beds and facilities). For what it is worth (which is not that much, given the long time frame the government cites), the province claims it will increase hospital capital spending over the next 10 years from $11 billion to $20 billion – or on average to about $2 billion per year. But, this is just a notional increase from the previous announcement of future hospital capital spending. Moreover, even if we did take this as a serious promise and not just a wisp of smoke, the government's own reports shows they have actually funded hospital infrastructure about $3 billion a year over the 2011/12-2015/16 period. So this “increase” is really a decrease from past actual spending. Even last year's (2016-17) hospital capital funding increase was reported in this Budget at $2.3 billion - i.e. about 15% more th

The hospital crisis: No capacity, no plan, no end

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staﬃng. Less and less of hospital spending is on staff. Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development. It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staﬀ per capita than hospitals in Ontario. Overall, if Ontario had the same staﬃng capacity as the other provinces and territories, there would be another 33,778 full t

Defend Public Healthcare

Search This Blog