Greenville, South Carolina, November 1, 2010—CareChex, a division of The Delta Group specializing in rating the quality of hospital and physician care, released a new study, An Assessment of the Quality of University Hospital Care in the U.S., that investigates whether or not university hospitals outperform other hospitals on objective measures of quality. Importantly, to accurately assess the relative quality of care provided by university hospitals, the study removed unusually difficult cases (i.e., outliers) and adjusted for differences in patient risk factors (i.e., clinical and demographic characteristics).
Study results were surprising: While university hospitals do very well as a group in cancer care and in overall medical care, in many clinical categories they either performed the same as non-university hospitals or sometimes far worse. For example, 89% of university hospitals fall below the national average in orthopedic care, and 85% fall below the national average for general surgery.
CareChex looked across all key components of quality available for comparison – process, outcomes, and patient satisfaction – to form a single composite percentile score and attendant quality ranking. A total of 118 university hospitals were evaluated using The Delta Group’s National Quality Rating Database (NQRD), which includes virtually all general, acute, non-federal U.S. hospitals.
"Most people assume that a university hospital will provide better quality health care because these institutions typically conduct cutting-edge academic research, have lofty reputations and adopt the latest treatment protocols and technologies," says Dr. Thane Forthman, Managing Principal of The Delta Group. “We were especially surprised to see the study reveal that some of the nation’s best-known university hospitals scored in the bottom quartile of all hospitals nationally for overall quality of hospital care.”
“Certainly more research is needed, but at university hospitals you have a large population of interns and residents who are still being trained. While under the supervision of an attending physician, they have the autonomy to make rounds, order lab tests and make clinical decisions, even though they lack time-tested, hands-on experience,” says Forthman.
“More importantly, interns and residents often work extended shifts of up to 80 hours per week, which empirical research has shown dramatically increases fatigue-related medical and diagnostic errors, medication errors and other adverse events.”
“Regardless of the potential factors contributing to the issue, patients should consider the quality of care provided by all hospitals in their market before making the assumption that a university hospital will provide superior care.”
Among the key CareChex study findings:
* University hospitals appeared more frequently in the top 10% of all hospitals nationally in cancer care and overall medical care: 43% of university hospitals studied performed in the top 10% nationally for cancer care, while 17% performed in the top 10% for overall medical care.
* Surprisingly, many highly-regarded university hospitals performed in the bottom 25% of all hospitals nationally for overall quality of hospital care, including: Emory University Hospital, Dartmouth-Hitchcock Memorial Hospital, George Washington University Hospital, Georgetown University Hospital, Hospital of University of Pennsylvania, Stanford Hospital, Shands Hospital at the University of Florida, The Johns Hopkins Hospital, The University of Chicago Medical Center and University of North Carolina Hospital (Chapel Hill).
* Of the 118 university hospitals evaluated, 17 were in the top 10% of all hospitals nationally for overall quality of care in three or more clinical categories:
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