Q. What is the Colorado Hospital Report Card and what is its purpose?

A. The Colorado Hospital Report Card is a tool to help consumers make informed decisions about healthcare. It provides the public with clinical data to help measure the quality of healthcare in Colorado hospitals.  The report card allows consumers to conduct an interactive search to compare information from specific hospitals.

The primary purpose of the Colorado Hospital Report Card is to ensure that statewide hospital data and clinical outcomes are made available to the public in a clear and usable manner. The report card upholds a statewide commitment to hospital quality improvement, accountability and transparency.

Q. What was the process that led to the development of the Colorado Hospital Report Card?

A. The Colorado Hospital Report Card was created as a result of House Bill 06-1278 (sponsored by Representative Paul Weissmann, D-Louisville and Senator Maryanne Keller, D-Wheat Ridge), which required general hospitals in Colorado to report clinical measures, which would allow consumers to compare healthcare services at these facilities. This data was required to be made available on a website that enables consumers to conduct an interactive search to compare information from specific hospitals.

The Colorado Department of Public Health and Environment (CDPHE) is the responsible for monitoring the development and implementation of the Colorado Hospital Report Card. CDPHE selected the Colorado Hospital Association (CHA) to create and maintain the Colorado Hospital Report Card. CHA is responsible for the implementation and ongoing evaluation of the Colorado Hospital Report Card.

Q. How was data selected to be included in the website?

A. CHA?s Hospital Report Card Implementation Committee is composed of a broad membership from the healthcare community including representatives of hospitals, public health officials, quality improvement organizations, insurers, buyers and business leaders. This committee is responsible for identifying and recommending the necessary elements of the Colorado Hospital Report Card. The committee meets monthly to evaluate the effectiveness of the report card, and recommend new measures to be included in future iterations of the report card.

The Colorado Hospital Report Card uses standardized quality and clinical outcome measures endorsed by national organizations for measuring the performance of healthcare providers and hospitals. The measures were selected because they are consistently defined by all hospitals and because they are reliable, valid and statistically significant.

Although the long term goal of the report card is to include measures that apply to all demographics and diverse communities, there are some measures that may not be appropriate to use for direct comparison of some hospitals, given the nature of the patient population, size of hospital or frequency and number of procedures. Appropriate consideration for applicable measures will be given to all types of hospitals throughout the state to ensure a process of accountability for hospital practices and development of quality improvement initiatives for best delivery of healthcare in Colorado.

Q. What is the source of the data?

A. The data used for the report card is collected by the Colorado Hospital Association (CHA). It comes from information hospitals compile for billing purposes. These records, referred to as "administrative data", consist of diagnoses and procedures along with information about the patient's age, gender, accompanying medical conditions and discharge status. While administrative data cannot be used as the single source of information on healthcare quality, it can provide information about the medical care that is delivered by Colorado hospitals.

Discharge data reflect the care provided to patients who were discharged from the hospital in 2004, 2005 and 2006. Patient and physician names are removed to ensure confidentiality. If a hospital had fewer than 30 patients with a specific diagnosis or procedure in a year, the data are aggregated for three years so the lower volume hospitals can participate in reporting quality information. If a hospital had fewer than 30 cases over the three years, no comparative rates were calculated because the results would not have been statistically reliable.

Discharge claims data is collected from all general hospitals in Colorado and analyzed using statistical software. CHA checks the data for transmission and processing errors. Hospitals review the data and correct mistakes to ensure accuracy in the information that was submitted. Individual hospitals are compared against the state average for each individual quality measure, and a score for each individual hospital is generated based on that comparison.

Q. What is the best way to use these reports?

A. Decide which quality measures are the most relevant to your health and interests, and review the data for those quality measures. Look to see if the hospitals you are interested in are listed. If a certain hospital is not listed, it means that the hospital did not have enough patient cases to do statistical analysis of that quality measure.

Hospitals are arranged alphabetically by geographic area. You may wish to compare the performance of hospitals that are in the geographic area closest to where you live or review those hospitals that are covered by your health insurance plan. Each table/graph provides the results for specific hospitals, as well as a statewide average.

Review the hospital's comments. It is especially important to view the hospital's comments if their score for a quality measure is lower than expected.

Compare the hospital's performance over time by reviewing the three-year trend report.

As with all data, context and appropriate interpretation are needed for the information to be meaningful and useful. Talk with your physician, your hospital, your family and friends about the information, and discuss their experiences and recommendations as part of making a decision about where to obtain hospital care.

Q. What other factors should I consider when deciding where to go for healthcare

A. Many factors influence which hospital to choose for medical care. Quality measures are only one source of information to consider. Other factors that may affect where you receive care include the hospitals your health plan covers, where your doctor practices, location and convenience. It?s a good idea to discuss the Colorado Hospital Report Card with your doctor, as well as your family and friends to learn about their experience. Having this information will allow you to take a more active role in making healthcare decisions.

The report card should be used in conjunction with other tools that evaluate hospitals and physicians, such as the Centers for Medicaid and Medicare Services? (CMS) Hospital Compare, which can be found at www.hospitalcompare.hhs.gov.

Q. Are the comparisons between hospitals appropriate?

A. Because of their individual areas of expertise, some hospitals may treat more high-risk patients, or see patients that are sicker or less healthy than others (a higher level of severity). These and other factors can make comparing hospital death (mortality) rates for patients with the same illness, but different health status, difficult. To compensate for this, the mortality data for each hospital is "risk-adjusted" to reflect the mortality rate the hospital would have had if it provided services to a mix of patients with an average degree of illness and complications. Risk adjustment is a method of converting complex data into a format that makes it easy to compare information.