Does the Healthcare Advisor only use data on Medicare patients (patients over 65 years old)?

State data sources are used whenever possible; however, some states do not make their data available. Here is a list of the inpatient data sources currently used in the hospital selection area of the Healthcare Advisor:

The source for inpatient Medicare data is the Centers for Medicare and Medicaid Services (CMS). The sources for inpatient state data are:

• Arizona: Arizona Bureau of Statistics
• California: California Office of Statewide Health Planning and Development (OSHPD)
• Florida: Florida Agency for Health Care Administration (AHCA)
• Iowa: Iowa Hospital Association Maine: Maine Health Data Organization
• Maryland: Maryland Health Services Cost Review Commission (HSCRC)
• Massachusetts: Massachusetts Health Data Consortium (MHDC)
• Nevada: Nevada Division of Health Care Financing and Policy
• New Hampshire: New Hampshire Department of Health and Human Services
• New Jersey: New Jersey State Department of Health
• New York: New York State Department of Health
• North Carolina: North Carolina Health Information Network
• Oregon: Oregon Association of Hospitals (OAH)
• Pennsylvania: Pennsylvania Health Care Cost Containment Council (PHC4)
• Rhode Island: Rhode Island Department of Health
• South Carolina: South Carolina Hospital Association
• Texas: Texas Hospital Inpatient Public Use Data File, Texas Health Care Information Council, Austin, Texas
• Utah: Utah Health Data Committee
• Virginia: Virginia Hospital Association
• Washington: Washington State Department of Health
• Wisconsin: Bureau of Health Information, Division of Health Care Financing, Department of Health and Family Services, State of Wisconsin

Are the data on the site adjusted for risk or severity of illness?

Yes. Complication, post-operative infection, and mortality data by hospital are risk-adjusted using methodologies developed by Solucient and based on the research of clinicians. These methodologies have been continually refined and tested.

These methodologies are designed to allow comparison of inpatient outcomes (complication, post-operative infection, and mortality rates) among hospitals in a way that is meaningful and fair. These methodologies account for many patient factors, including age, gender, clinical diagnosis and procedure codes, and co-morbidities (other illnesses or injuries the patient has), as well as hospital characteristics (for example, teaching status, urban vs. rural location, and facility size), to determine the expected, or predicted outcomes for each patient.

Note that major teaching hospitals often treat the most severely ill patients, and the risk-adjustment methodologies currently available may not fully account for the risks of complications, post-operative infections, and deaths for these patients. This may cause these hospitals to have a worse rating than if the methodologies accounted for all possible factors.

How do I know that the data are based on a sufficient number of cases to be meaningful?

We adhere to cell suppression rules - in other words, we do not report any number or statistic that is based on (or could be used to reveal) a patient volume that does not meet the rules established by the Centers for Medicare and Medicaid Services (CMS, formerly HCFA) or the states supplying the data. These cell suppression rules are in place to protect patient confidentiality and privacy, and all websites using these data sources are required to adhere to the same rules.

On the Healthcare Advisor, cell suppression rules are required for the following statistics: "Patients Treated in One Year" and "Severely Ill Patients Treated in One Year." When patient volume does not meet these rules, you will see a label of "n/a."

In addition, the Healthcare Advisor employs a statistical test when comparing actual and expected Complication, Post-Operative Infection, and Mortality rates, to determine whether a hospital's rate is "As Expected," "Better than Expected" or "Worse than Expected." This comparison takes into account the characteristics - including severity - of the patients the hospital treats. We do not perform this test in cases where cell suppression rules do not allow us to display patient volume information. In these cases, you will see a label of "Insufficient Data."