Measuring Quality of Care: Study Ranks Catholic Health Systems Best, For-Profits Worst
Filteau, Jerry, National Catholic Reporter
Catholic-owned U.S. health systems "had significantly better quality performance" than investor-owned, for-profit systems, says a national study by Thomson Reuters.
The study found that other church-based systems ranked slightly behind Catholic systems. Secular not-for-profit systems ranked third, and for-profits came in last among the four types of ownership.
Thomson Reuters is a leading analyst of business and leadership practices in health care, science, media, and a wide range of other fields.
Its analysis, "Differences in Health System Quality Performance by Ownership," was based on a study of 255 U.S. health systems, each of which included at least two short-term, general, acute-care hospitals in its system.
Based on public health data, the Catholic hospitals were less likely than their counterparts to have the patients with the same type and severity of illness die or suffer complications in the hospital. Their comparable patients were also less likely to die or have to be rehospitalized within 30 days for heart attack, heart failure or pneumonia. On average, patients with comparably severe illnesses had shorter stays in Catholic hospitals as well as better outcomes.
The key clinical criteria of an institution's record of patient mortality, safety and complications were all weighted by standard risk adjustment for different kinds of illness and other factors.
In addition, patients in Catholic facilities generally reported higher levels of satisfaction with their hospital's performance.
The report found:
* "Catholic and other church-owned systems are significantly more likely to provide higher quality performance and efficiency to the communities served than investor-owned systems. Catholic health systems are also significantly more likely to provide higher-quality performance to the communities served than secular not-for-profit health systems.
* "Investor-owned systems have significantly lower performance than all other groups."
According to the study, health systems--groupings of more than one hospital--"were founded for economic purposes" such as better access to capital, economies of scale in purchasing, and increased negotiating power with suppliers and payers.
With economics as the primary driving force, "the responsibility for quality of care in most health systems was delegated to local hospital governing boards," the report said.
"The findings of the study suggest a changing role for health system governance and leadership," said Jean Chenoweth, senior vice president for performance improvement and 100 Top Hospitals programs at Thomson Reuters.
"Our data suggest that the leadership of health systems owned by churches may be the most active in aligning quality goals and monitoring achievement across the system," she said.
Leadership teams of investor-owned systems "may be adopting a [quality achievement] responsibility more slowly" she said.
The report suggested that with the Obama health care reform's increased emphasis on rewarding performance and efficiency Catholic and other church-run health care systems may benefit significantly more than other health care operators, at least initially, because they already have a track record of leadership in those areas.
"As the industry reacts to health care reform legislation, including pay-for-performance initiatives and new tax rules that could stress certain ownership types more than others and change the balance of ownership types," the report said, "assessing relative alignment of system hospitals with corporate goals will become a critical tool for both system management and governance."
This reporter translates that complex bureaucratic research language into: Catholic and other church-owned health care systems already drive health care performance and quality assurance at the corporate/system level rather than leaving it to local hospital boards. …