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Fraser Institute gives LGH a bill of health

VCH warns patients not to use data to select hospital care

LIONS Gate Hospital received a clean bill of health in almost every area from the Fraser Institute's Hospital Report Card, but the health authority is warning people not to use the data to compare hospitals.

Patients at Lions Gate are less likely to die from acute strokes and hip fractures than the provincial average, while cases of preventable trauma during cesarean delivery were also well below the rest of B.C., according to statistics leading up to 2008/09.

In most areas where the hospital showed poor health results in previous years, the last three years have shown improvement. The pneumonia mortality rate, for example, was statistically significantly higher than the provincial average for three out of five years leading up to 2005/06, but since then has been below the provincial average three years running, including two years where the difference was statistically significant.

"It's really changed," said report author Nadeem Esmail, pointing out that line as he poured over the statistics.

"There doesn't appear to be, aside from that one, any area where the indicators are suggesting a serious concern," he said.

While Esmail hopes the report will be used by patients to determine where they can get the best care and to hold their hospitals accountable, Vancouver Coastal Health spokeswoman Anna-Marie D'Angelo said the comparison between hospitals is apples to oranges, as patients arrive at hospital in different condition.

"It is of concern to us that people would make decisions based on this poor information, because it could be a safety issue. We encourage everyone that if they have to go to hospital, to go to the nearest hospital," she said. If people don't, she added, they could end up getting sicker on the way to hospital, creating further complications for doctors, or having to be transferred back to the same hospital the patient passed over.

She added that some hospitals specialize in specific areas and receive patients from across the province, whereas others, like Lions Gate, provide general community care.

"How our health service works is we work together, we're not in competition. If someone has a heart attack on the North Shore, they go to Lions Gate Hospital, and if it's severe enough you might transfer to St. Paul's. . . ," she said.

Still, D'Angelo said she was pleased with the results from Lions Gate as well as other options in the health authority, and said if patients do use the report, it should be to compare performance at the same hospital over a length of time. She said staff would review the report.

"We welcome any report that can help us improve our patient care and safety," she said.

Esmail disagreed on the usefulness of the data, arguing their method of comparison is used in 12 U.S. states and has been specially adapted to Canada. The report also lists an indicator that handicaps each hospital's score based on the condition of the patient when they arrived at hospital.

While he said the differences between hospitals aren't always the result of patient care, the aim has been to factor out other influences.

"If you're an individual going into a hospital you now have the opportunity to look up the performance of a hospital over time to understand if there may be issues at this hospital regarding particular areas of care, and if a hospital is experiencing success," he said.

British Columbia is the only province that releases statistics for hospitals along with the name of the hospital. Other provinces provide the statistics without attaching the name.

The report can be viewed online at www.hospitalreportcards. ca/bc.

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