Las Vegas Sun

October 25, 2014

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DO NO HARM: HOSPITAL CARE IN LAS VEGAS:

A breakthrough in medical transparency

There’s a running joke about hospitals here:

“Where do you go for great health care in Las Vegas?”

“The airport.”

The implication is everyone knows hospital care in Southern Nevada is substandard.

The reality, however, is that almost no one has had access to meaningful information about the quality of Las Vegas-area hospitals.

Until now.

The Sun on June 27 launched an ongoing report about hospital care in Las Vegas.

As part of a two-year investigation, Sun reporters Marshall Allen and Alex Richards have obtained a record of every Nevada hospital inpatient visit going back a decade — 2.9 million in all. The information, coupled with interviews with more than 150 patients and health care insiders, has yielded a sweeping and detailed portrait of hospital care in Las Vegas.

Revealed are the dangers patients have unknowingly encountered as they enter delivery rooms, surgical suites and intensive care units, including thousands of cases of injury, death and deadly infection associated with stays in Las Vegas hospitals.

There have been previous red flags about hospital safety. A suicidal patient, for instance, recently hanged himself while under observation at MountainView Hospital, and a woman in labor was ignored at University Medical Center, leading to a miscarriage.

A recent study found that Nevada hospitals have the worst rate in the nation of readmissions, meaning discharged patients needed to return within 30 days to the hospitals for additional care.

But the public has not known the scope of the problems, even though the state has been gathering inpatient data since 1986. The data, gathered primarily for cost-control purposes, are based on individual hospital billing records that state law mandates be collected for the purpose of analysis.

The state contracts with UNLV to maintain the records, which do not contain identifying names, birth dates or addresses, nor the dates patients were hospitalized. The data also leave out clinical details, so they’re not the same as medical records. Rather, they signal trends and warning signs that warrant further investigation.

Until now, Nevada hospitals have succeeded in controlling the release of this information to the public. The result: In a state where gamblers can easily access the odds on any video poker machine, hospital patients have had no way of knowing how frequently harmful outcomes occur where they receive their most sensitive health care.

But now, with tables and interactive online charts, much of that information is available in the Sun.

Dr. John Santa, director of the Health Ratings Center for Consumer Reports, a national nonprofit organization, said he has not heard of another organization, in journalism or otherwise, analyzing inpatient hospital data in a way that’s transparent to the public.

“This is the first step in getting to a new and different and better relationship between hospitals and physicians, and patients and the public,” Santa said.

Helen Haskell, director of the national advocacy group the Empowered Patient Coalition, said the Sun’s analysis will allow patients to make better-informed decisions about where to seek care, exerting financial pressure on low-performing health care providers to improve.

Because most states have similar databases, the Sun’s investigation can be replicated, imposing a new era of transparency within the hospital industry.

“This is the Holy Grail,” Haskell said. “What every patient wants is provider-specific information about outcomes.”

Assembly Speaker Barbara Buckley, a longtime legislative advocate for improving health care, lamented it was a newspaper that has brought this information to light instead of state regulators who have had the data for years.

“Do you have the right to know about the quality of care you’re receiving? I think you do,” she said. “When you buy a car, you can go to Consumer Reports. Isn’t someone’s life worth more than his car? I would think so.”

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