Where will the best health care come from? | Eastern North Carolina Now

     Publisher's Note: We do very much appreciate this fine article on the BRHS debacle from our friends of the Beaufort Observer.

Beaufort County Medical Center

    As we enter the short rows in the Hospital debate, one of the things we've been asked about and keep hearing some people talk about is how much better the quality of health care will be with one provider than another. In the interest of informed community debate we have done some research on the question of how the quality of medical care compares between Beaufort County Medical Center (Beaufort), University Health Systems (UHS), including Pitt Memorial and Community Health System's (CHS) hospitals. We gathered our data from the full proposals originally submitted by both UHS and CHS. The CHS data includes Beaufort's.

    The data are taken from a website maintained by the U. S. Department of Health and Human Services that can be accessed at: www.hospitalcompare.hhs.gov. The data can be a bit daunting but basically here is what it shows.

    The data give the results of "Patient Satisfaction Surveys" that are used at most hospitals in the nation. The results are reported as the percent of patients who gave the hospital the top ratings on the survey. We focused on the "Overall Rating" and those patients who reported that they would "definitely recommend" the hospital to their friends or family members. The results are reported by individual hospitals in each system rather than as a composite for each health system.

    You can download the actual data included in the original proposals from UHS and CHS by clicking here.

    Here is the conclusion we came to after reviewing the data: There's not a significant difference in the quality of the three systems, as perceived by the patients. There is, in fact, more variance in quality within each system than there is between systems.

    But for the number crunchers, we'll offer these points:

    • Beaufort had an overall patient satisfaction rating in 66% in 2009 and 67% said they would definitely recommend Beaufort.

    • Pitt Memorial had an overall patient satisfaction rating of 77% in 2009.

    • Within the UHS system, Duplin had the lowest satisfaction rating in 2009 with 69% while Bertie rated an 84% satisfaction rating.

    • CHS's average for its NC, SC and VA hospitals was 66% but the variance ranged between 54% (Southside, Petersburg, VA) and 75% at Carolinas, in Florence, SC.

    • For the purists among us it should be noted that the CHS sample was nearly twice as large as UHS's so there is apparently some regression to the mean operating. None of the results appear to be adjusted for size of sample.

    We learned that some variance in these kinds of data is typically exhibited in relation to the type of services provided. We were told, and it seems supported by the limited amount of data we reviewed, that patient satisfaction tends to be higher the more complex the services provided. Heart patients tend to rate their satisfaction higher than emergency department patients, for example. Thus, the reader might be advised that a tertiary care facility (one that has more high-specialty services) might be skewed to the high side while those hospitals like Beaufort's may be skewed to the lower patient satisfaction side. But we would also note, just based on "eyeballing" the data as it has been presented to several meetings of the Beaufort board in recent months, there is significant variation from month to month and the averages at all three operations appear to be pretty much within the overall variance trends. But unfortunately (for the statistical purists among us) the data do not report any kind of measure of variance, so this means we can not put too fine a point on the relatively small differences reported. That's just another way of saying that there is more difference within than there is between the organizations.

    The conclusion we came to after spending quite a bit of time on these data is that the difference between the operations is not sufficient to be a determinant of which offers the better deal. They are all very good providers according to those who have experienced their services.