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Consumer Reports rates local hospitals on surgery outcomes for seniors

Published Aug. 2, 2013

TAMPA — Just two weeks ago, Tampa General Hospital celebrated its ranking by U.S. News & World Report as the second-best hospital in Florida.

But this week a Consumer Reports guide put Tampa General at the bottom of the list in Florida when it comes to how elderly patients do after surgeries. Joining TGH in the back of the pack were Morton Plant Hospital in Clearwater, Shands at the University of Florida and Orlando Regional Medical Center.

Near the top of the list? St. Anthony's Hospital in St. Petersburg and Citrus Memorial Hospital in Inverness.

The local rankings fit into a surprising overall theme of the new Consumer Reports guide: Many of the nation's best-regarded hospitals didn't do as well as their smaller, lesser-known counterparts.

How Consumer Reports reached its conclusions is somewhat controversial. Researchers analyzed Medicare claims data from 2009 to 2011 for more than two dozen procedures, including back surgery, vascular surgery, and hip and knee replacements. Consumer Reports then evaluated the hospitals based on whether patients died in the hospital or stayed longer than expected after their surgeries.

TGH spokesman John Dunn said billing data does not give as full as a picture as clinical records. A patient coming in for a hip replacement, for instance, may have myriad existing problems that complicate recovery.

He added that TGH, as a safety net hospital, takes "the sickest of the sick." On the whole, teaching hospitals such as TGH did not do better than average in the rankings.

"I think the fundamental weakness is they're relying on billing data," Dunn said.

Doris Peter, associate director of Consumer Reports Health Ratings Center, said researchers developed a model to take into account pre-existing complications. For instance, medical codes indicate whether a surgical patient is admitted with hypertension, she said, so the model makes allowances.

"The idea is that these models adjust for these problems," she said.

BayCare Health System, Tampa Bay's largest health care provider, includes both the high-ranking St. Anthony's and low-ranking Morton Plant Hospital. Spokeswoman Beth Hardy said patients shouldn't use only the Consumer Reports guide when making a decision about where to get surgery. "It's one tool in the toolbox," she said.

For one, it looks only at older patients. "It's unlikely these data are a good idea of what non-Medicare patients should expect," she said. Also, she noted, hospitals often keep elderly patients in their care longer because they don't have anyone to help them at home while recuperating.

Peter, the Consumer Reports director, acknowledged that the ratings are just one indication of a hospital's performance. "It's not a perfect proxy," she said. She said researchers didn't have an explanation for why the smaller community hospitals did better than the larger ones. Critics of their method, she said, had expected the exact opposite.

Jodie Tillman can be reached at jtillman@tampabay.com or (813) 226-3374.

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