Staff Writer

ONEONTA —Area hospitals ranked at the state average for all but a couple of categories in a report card released Monday for hospitals throughout the state.

The study, developed by the Alliance for Quality Health Care and the nonprofit Niagara Health Quality Coalition, rates more than 200 hospitals for their treatment of six potentially life-threatening conditions, such as pneumonia, and lists mortality rates for seven medical or surgical procedures. Relative mortality rates for other conditions, such as stroke, were also included.

The listings, broken down by region, were compiled from billing information reported in 2001 to the state Department of Health.

A.O. Fox Memorial Hospital in Oneonta received a worse than average rating for hip replacement mortality, according to the report, and had a higher than average use of Caesarean sections.

"We have an excellent orthopedic surgeon at Fox, so I'm not willing to say that we are below in orthopedics," said Maggie Barnes, Fox's director of community affairs. "We'll look at all the areas and evaluate them."

Mary Imogene Bassett Hospital in Cooperstown received a below average rating for acute stroke mortality rate. Bassett officials said they were surprised by the rating, as the previous year the hospital had been ranked by the HCIA-Sachs Institute among the top 100 hospitals in the nation in quality of care for stroke patients. Five other hospitals in the state received that ranking.

"What you have to realize when looking at patients of stroke is that a couple of mortalities can significantly alter those numbers," said Bassett's Vice President of External Affairs Michael Stein, who added that since smaller hospitals frequently refer patients to Bassett, the hospital often gets some who are already very sick.

Hospital officials wondered if the data was truly risk-adjusted and said the analysis does not take into account the rate of referrals and the large area Bassett serves.

Risk adjustment is based on patient demographics, aiming to give the best estimate of what a hospital's rates would be if it had a mix of patients similar to the national average, according to the Alliance website. The Alliance said it used All Patient Refined DRG, risk-adjustment software by 3M.

Bassett also had a lower than average use of Caesarean sections and was named to the report's honor roll for pneumonia mortality.

"There's been a major concentration here on doing Caesarean sections only when it's the most appropriate method of delivery," Stein said.

Spokespersons for both hospitals stressed that it was important for consumers not to rely solely on the report.

"There is no replacement for actually visiting the facility, asking questions, getting recommendations from family and friends and talking to your doctor," Barnes said. "This information is not meant to replace that."

Dr. Andrew Raucher, medical director at Bassett, said, "These reports should be used as a guide and give the patient information to take to their physician."

This is the first year the Alliance — an organization sponsored by 3,600 employees and 31 insurance companies — and the Niagara Coalition conducted the study, according to Brian Boissonnault, executive director of Niagara and president of the Alliance. Boissonnault said the report is unique and that other hospital report cards — although providing complementary information — were not competitive.

"This will make health care better," he said. "Nothing sanitizes like the light of day."

The state Department of Health posts physician profiles on its website and is in the process of preparing hospital report cards. Bassett officials said they supported a state study including input from hospitals.

"I think the one problem with private organizations is that you never know how exactly they are using the data and what data they are using," Stein said. "Even though they publish their methodology, it's complex. Two separated organizations can be looking at the same data sets and come up with two different analyses."

Both hospitals reported they have internal organizations that do quality analysis on a continual basis.

"We look at anything that is said about our quality of care," Barnes said. "We take that very seriously."

The report is available online at www.myhealthfinder.com.