Winnipeg Free Press - PRINT EDITION

Winnipeg hospitals fare well in review

Close to national average, online study finds

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Manitobans can now compare how well their hospitals stack up against one another and to others across Canada.

The Canadian Institute for Health Information released its online health system performance review on Wednesday to show Canadians which hospitals across the country have fewer readmissions for treatment after major surgery, heart attack, stroke and hip and knee surgery.

The web-based tool (www.cihi.ca) also tracks which of the more than 600 acute-care hospitals across Canada saw fewer deaths after major surgery and which ones did the best financially.

Hospitals in Winnipeg are generally close to the national average on most counts.

However, don't expect it to read like a school report card -- you've got to know what you're looking for and what the numbers mean.

Dr. Michael Moffatt, executive director for research and applied learning at the Winnipeg Regional Health Authority, said the website's wealth of information will be used more for administrators to compare their performance with others hospitals to see where they can improve.

"It's the first time that any of this bench-marking data has been publicly available," Moffatt said. "It's an important form of accountability."

How well Manitoba measures up to other provinces, in four years of data collected by the independent CIHI, sees some good news and bad news, said Kira Leeb, CIHI director of health system performance.

On the plus side, Leeb said the most recent data shows that in 2010-11 Manitoba had a lower mortality rate within five days of major surgery than the national average. The Manitoba rate is 6.14 per 1,000 cases compared to 9.26 per 1,000 nationally.

"There is quite a bit of difference," Leeb said.

Manitoba also fares better than the national average when it comes to treatment of "nursing-sensitive conditions," such as falls, bed sores or urinary tract infections, for medical and surgical patients.

The province's hospitals also collectively do better than the national average for birth trauma and for the lower number of caesarean births performed each year, Leeb said.

But she added Manitoba has a higher rate than the national average for readmissions after 30 days following a hospital stay, including for obstetrical patients.

Moffatt said the WRHA is examining those numbers to see why.

Leeb said the CIHI does not track why these numbers are higher, but only points it out so the public has the information and that administrators know which areas in patient care need improvement.

"The important thing is to start investigating when your results are different than the Canadian average, when there are variations in the differences that are quite significant," said Leeb.

Moffatt also said the downside to the information is that it just tracks performance hospital to hospital -- it doesn't recognize Manitoba and other western provinces have regionalized health-care systems.

"We try not to think of ourselves as six different hospitals, but as a region where we integrate care," he said. "Just because something looks funny at one hospital and really good at another hospital, it may be because we've created a centre of excellence at one hospital and don't have very many of those cases at another hospital."

For example, Winnipeg's Concordia Hospital, which saw the lowest five-day in-hospital death rate after major surgery among large community hospitals, is a centre of excellence for orthopedic surgery -- a significant number of surgeries at the hospital is related to hips and knees.

In all, the CIHI's Canadian hospital reporting project provides a series of 21 clinical indicators and nine financial indicators that allows hospitals to compare their performance with others.

Results for the financial indicators show facilities across Canada have generally reduced their administrative costs as a percentage of their total costs since 2007 -- administrative costs tended to be lowest in the western provinces.

In particular, hospitals in Winnipeg and Brandon fall below the national average for administrative service expenses.

"Our government has worked hard to get health administrative costs down and according to CIHI Manitoba moved from having among the highest administrative costs in Canada to among the lowest," said Health Minister Theresa Oswald.

bruce.owen@freepress.mb.ca

-- With files from Postmedia News

Report's findings

 

Among large community hospitals, mortality rates within five days of major surgery ranged from 2.2 per 1,000 at Winnipeg's Concordia Hospital to 16.5 per 1,000 at the University Hospital of Northern B.C. in Prince George -- an almost eight-fold difference.

The national overall readmission rate, which measures the rate of unplanned readmissions within 30 days after discharge, ranged from one per cent to 18.5 per cent. The national average was 8.4 per cent.

It costs, on average, about $5,000 to treat an acute-care patient. Hospitals in Winnipeg, according to the data, have a higher cost per weighted case than the national average, which means more money is spent per case.

"We do seem to spend a fair number of hours per case, which from a patient's point of view may be a good thing, but from a taxpayer's point of view, maybe not," said Dr. Michael Moffatt, executive director for research and applied learning at the Winnipeg Regional Health Authority. "We're certainly looking at that."

Manitoba has the lowest caesarean section rate in the country, and one of the highest rates of successful vaginal birth after a C-section.

The in-hospital cardiac mortality rate for the WHRA is 6.63 per 1,000 cases, compared to 7.66 nationally.

Republished from the Winnipeg Free Press print edition April 5, 2012 B2

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