Do Hospitals Kill People?

I know a few doctors, and most of those I know didn’t have a fun weekend. So far as I can tell, most of the city’s hospital administrators, health-care workers, managers, consultants and academics had a rotten time too. The reason: they are upset over the public reporting of hospital death rates, which were splashed across the cover of the Toronto Star on Friday.

One friend, who works at Scarborough General—which topped the list with a death rate of 134 (100 deaths is the average)—was particularly upset because it made her workplace look like a deathtrap. Just weeks ago, another Star front-page story showed the hospital’s region beset by an outbreak of diabetes. Her hospital’s patient population is sicker than many others, and that factors into the hospital’s score. She’s right, but only up to a point. Other hospitals with troublesome patient populations score much better. (Some might even score worse. Humber River Regional, another hospital whose patients are a public-heath challenge, refused to divulge its score. Wonder what that means.)

The more you dig into these numbers, the more fascinating they become. Here’s a subset comparison worthy of its own academic study: Sunnybrook scored a higher than average death rate of 104, which you could argue is pretty good, given that Sunnybrook is a regional trauma centre—which means they treat the worst trauma victims, from car crashes to gunshots. Except, St. Michael’s, which is also a regional trauma centre, registered a well below average score of 91. Why the difference? Is it that Sunnybrook handles more traumas? Are their cases truly that much worse? Or is it that St. Mike’s has some management techniques that result in better patient outcomes?

I have no idea what the answer is, but I suspect that Sunnybrook management is busy trying to find out. Same goes for Scarborough General; its patient population is only one of many reasons for its poor score, and they’ll want to hurry up and evaluate the problem. If the numbers had never been released, they probably wouldn’t bother. Get used to it: the future of public health care lies in public reporting. Information is less dangerous than secrecy.