Report identifies unnecessary care in Mass. hospitals: 5 findings

A Center for Health Information and Analysis report released Tuesday showed Massachusetts hospitals aligned overall with national averages for measures of effective processes of care, except for in a few areas.

"The findings of this report suggest that Massachusetts healthcare providers have an opportunity to decrease unnecessary care and the associated costs and risks," the report reads. "There is wide variation across hospitals in the use of cesarean sections and episiotomies and Massachusetts far exceeds the recommended rate for both procedures. Potentially avoidable admissions have recently improved for some conditions, but have declined on others, while the overall hospital readmission rate has only slightly improved over three years. Patient safety, as measured here, was inconsistent, with some hospitals having higher than expected infection rates and more risk-adjusted complications. Patient experiences with care appear to vary systematically by patient characteristics and health status. While factors influencing quality performance are complex, the results offer care providers and their institutions additional context as they work with their patient to achieve better outcomes."

Here are five report findings to know.

• A wide variation among acute care providers on maternity care measures and rates of certain maternity-related procedures far exceeded performance targets. The report identified a 29-percentage point difference between the highest and lowest hospital-specific cesarean rates. Also, early elective deliveries rose during 2014-2015 after a decline in previous years. These numbers suggest the spike could be due to the procedures being performed unnecessarily.
• Compared to national performance, the state of Massachusetts has done well in terms of potentially avoidable admissions for diabetes complications, but far exceeds the national rate of admissions for congestive heart failure and asthma.
• Overall, the state's patient experience ratings were in line with national averages for acute care hospitals, which the exception of hospital noise room level, which was 9 percentage points lower than the national average. The lowest scoring area for patient experience was for the monitoring of adult behavioral health — this statewide score was 30 point below the next lowest-scoring category. Examining patient experience by demographic also revealed significant differences between White, Black, Hispanic and Asian patients. White patients consistently rated their care higher than the other demographics.

• Most hospitals in the state performed as expected or better on CLABSI and MRSA infection, but several had worse than expected occurrences of CAUTIs, SSIs and hospital-onset C. diff infections.
• Among acute hospital with psychiatric inpatient units and psychiatric hospitals, a post-discharge continuing care plan was created for 69 percent of applicable hospitalizations. In 57 percent of these cases, continuing care plans were transmitted to the next care provider. On both measures, Massachusetts' statewide average was well below the national average.

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