Who selects the hospital?

As you know from the FEHBlog, the U.S. Department of Health and Human Services offers health care consumers, whether or not Medicare eligible, a helpful online Hospital Compare tool. The Washington Post reports today that

[A] national survey of 500 randomly selected Medicare patients by researchers at Dartmouth Medical School has found that nearly one-third of those who underwent major non-emergency surgery reported that their doctor had been the sole decision-maker about which hospital to choose. That number was greater than the 27 percent who said that they or their families had made the decision. The remaining 42 percent said they had decided along with their doctor.The study, which appears in the March issue of the Archives of Surgery and was funded by the federal Agency for Healthcare Research and Quality, is believed to be the first to analyze the role of patients in making such a decision.

Iit’s hardly surprising that the doctor plays a key role in selecting the hospital in non-emergency cases because a patient is limited to those hospitals where his or her doctor has admitting privileges. (Or they can switch doctors.)

Many years ago, I had a sinus surgery, and my doctor had admitting privileges at two hospitals in DC. I checked with nurses about the reputation of the two hospitals which made my choice easy. Perhaps today, I would use a tool like Hospital Compare or Health Grades and ask my medical friends (since then I have gotten to know a few doctors too).

This approach to health care quality was given a boost by the President’s August 22, 2006 Executive Order. Health plans often provide this service to their members, and Steve Case’s new company Revolution Health is offering the service for a fee.