Thursday, February 10, 2022

St. Dominic Scores Worst on Wasteful Health Care Index

 A Johns Hopkins study reported St. Dominic Hospital had the worst score of 375 hospitals in its overuse index for wasteful healthcare at  US hospitals. The study appeared on the JAMA website.

Johns Hopkins researchers  reviewed claims of Medicare beneficiaries from 2016-2018 for 17 "low-value services" in 375 hospitals and outpatient sites.  An index was created using a mean that rated hospitals in standard deviations below or above the mean.  Most subjects fell within +/-1.5 standard deviations of the mean.  The study stated: 

To describe the health systems, we categorized them according to their standardized Overuse Index and placed them in five categories.  Category 1 health systems have an Overuse Index more than 1 SD below the mean, category 2 is between -1 and -0.5 SD below the mean, category 3 is between -5 and .5 SD of the mean, category 4 is between 0.5 and 1 SD of the mean, and category 5 is more than 1 SD beyond the mean. On the following pages, we list the health systems in each category alphabetically by state and by name.  The health system ID is that assigned by the Agency for Healthcare Research and Quality and the city and state are for the home office of the health system. (p.14)

The average patient was 75 years old.  76% of the patients were women.

Five Mississippi hospitals were less than the mean while five fell between 0.5 and 1.0 standard deviations above the mean.  Unfortunately, the study reported the worst hospital was St. Dominic in Jackson.  St. Dominic was 3.11 standard deviations above the mean. (p.34) How bad was St. Dominic? Most of the hospitals in the worst category (5) were between 1.0 and 1.5 standard deviations above the mean. One hospital was 2.14.  The Jackson hospital was the only subject that was three standard deviations above the mean.  


 

The 20 worst hospitals were: 

1. St. Dominic Health Services (Jackson, Miss.)

2. USMD Health System (Irving, Texas)

3. Community Medical Centers (Clovis, Calif.)

4. Care New England Health System (Providence, R.I.)

5. East Alabama Medical Center (Opelika)

6. Pocono Health System (East Stroudsburg, Pa.)

7. University Health Care System (Augusta, Ga.)

8. Deaconess Health System (Evansville, Ind.)

9. Congregation of the Sisters of St Joseph of Peace (Englewood Cliffs, N.J.)

10. Iredell Health System (Statesville, N.C.)

11. Sacred Heart HealthCare System (Allentown, Pa.)

12. Southeast Health (Dothan, Ala.)

13. Chesapeake (Va.) Regional Medical Center

14. Butler (Pa.) Health System

15. CarolinaEast Health System (New Bern, N.C.)

16. Ohio Valley Health Services and Education Corp. (Wheeling, W.Va.)

17. Slidell (La.) Memorial Hospital

18. Lakeland (Fla.) Regional Health System

19. North Kansas City (Mo.) Hospital

20. Temple University Health System (Philadelphia)

The study also reported teaching hospitals generated lower incidents of wasteful care and frequently were below the mean (UMC was 0.55 standard deviations above the mean.) but investor-owned hospitals were more likely to provide wasteful care. 

 

Missisisppi Hospitals

Memorial Hospital (Gulfport): -1.73

Anderson Regional (Meridian): -0.18 

Forrest Health (Hattiesburg): -0.15

Greenwood Leflore (Greenwood): -0.38 

North Mississippi (Tupelo): -0.19 

South Central (Laurel): 0.42 

MBMC (Jackson): 0.81 

Rush (Meridian): 0.53 

Singing River (Gautier): 0.82 

UMC (Jackson): 0.55

 

 

22 comments:

Anonymous said...

Still not as bad as UMC. They leave their doors open late at night and armed felons have been walking in. I think one was hiding in a bathroom.

Anonymous said...

All I know is that parking sucks at both SD's and UMC. Suuuuuuucks .

Anonymous said...

BCBS MS considers annual PSA test low value, so much that they don’t cover or pay for it as part of their Healthy You checkup. Dr. says only way to detect prostate cancer early. So, I still do it, and contribute to low value ratings I suppose

Anonymous said...

1057 I guess you are one of those folks that think you deserve front door, ground level parking wherever you go, because of course, you are important and don't need to be inconvenienced.

Just what the hell do you expect places like these hospitals to do to accommodate your holy self? They have both built large parking garages, convenient as possible while still maintaining the ability for traffic to flow. And at St D medical tower, they allow you to drive up to the front door and will valet your car to the garage for you.

At the UMMC campus (an important word there, as the hospital is part of a university campus as well) there is a large parking garage on site within a short walk to the main hospital. Employees park across the street at the Veterans Stadium.

What do you do when you go to the grocery store or shopping center - park in the handicap spaces adjacent to the front entrance so that your holiness won't have to walk more than a few paces?

Albert Schweitzer said...



No $urpri$e here





Anonymous said...

So, to be sure I understand: "wasteful healthcare" is their definition of overused and unnecessary actions? Basically, unneeded testing and treatments? Sincere question. The premise of the study was unclear to me, so I'm just trying to make sure I'm understanding what the study is analyzing

Anonymous said...

@11,57
I couldn’t find what was considered “wasteful” either.

Kingfish said...

All right. Your comment was fine til the last word. Golf foxtrot Yankee won't get it done.

Anonymous said...

So they were giving my wife more pills and uneccessary pills than they should have ? Turned her into a damn zombie. All she went in there for was to talk about the issue that had her down.

Anonymous said...

For years St D was our hospital of choice. Not anymore. It’s definitely $$$ over care. We have been well pleased with Baptist care and service.

Anonymous said...

@11:32 AM - you may need a new doc. Mine was detected by a DRE (digital rectal exam), followed by a ultrasound guided biopsy. My PSA was very low and would otherwise indicate that I did not have PC. Treatment was proton radiation.

Anonymous said...

Can any medical professionals or anyone who has played one on tv weigh in on those 99.00 heart scans St. D offers? Just sounds like data gathering or fishing for patients.

Anonymous said...

Two of the handful of measurements were MRI's ordered for low back pain and surgeries performed for low back pain. Low back pain isn't considered a major indicator of need for either MRI's or surgeries.

Bill Dees said...

@10:39 AM, you have no idea what statistics are, or what they indicate.

Anonymous said...

Mayo Clinic in Rochester, Mn will change your. Thoughts of going to any of these Ms hospitals.

Anonymous said...

Baptist offers a heart screening as well for a low fee. OF COURSE it's fishing for patients, but when you find a 75% blocked carotid artery or coronary arteries that have so much calcium in it that a heart attack is very likely over the next five years you're not overusing - your saving lives. "Overuse" means something as long as it's not YOUR back that's hurting, as long as it's not your belly pain that could be an impacted kidney stone vs perforated diverticulitis.

Anonymous said...

@1:55…

As someone who works in the field of emergency medicine and has no ties to any hospital here, I would not take a sick rat from the sewer to Baptist for care. I work in and out of every hospital in the region and Baptist is by far the worst hospital, cares they least about their patients in the emergency setting, laziest nurses, laziest ER physicians, etc. That is literally the emergency department you go to if you want to die.

Anonymous said...

Took my wife to Mayo. I thought I was on a different planet. Aside from the top notch health care, not a blade of grass was out of place. No litter on the ground.
I was shocked at the cornerstone on the Gonda Building. It said "1955." The building looked brand new to me, clean and well maintained.

Anonymous said...

Bill Dees - Take another Zoloft. 10:39 said nothing about statistics.

Anonymous said...

What this is is an indictment of the medical staff and staff leadership. Should the physicians on the staff be keeping an eye on unnecessary MRIs of the spine or hysterectomies? Absolutely. That is their job. Should the medial staff leadership be monitoring the performance of its spine surgeons (neurosurgeons and orthopedists? Absolutely. It almost looks like if a lame dog wandered by this Lakeland Avenue hospital, it would get a spinal fusion.

The numbers are far out of line with any sense of reason. The medical staff, charged with the responsibility of quality of care, has fallen flat on its face.

Anonymous said...

9:53, I have to disagree about Baptist. My wife has been to UMC and Baptist ER 2x each this past year. Baptist was better by far, far less waiting time, and excellent care from the doctors and nurses. The doctors and nurses at UMC ER were also very good, it was just they were overwhelmed with patients, which made the wait time much too long. I will also say that my wife has been through cancer treatments at UMC, and we have been very pleased with the care she has received. She had the blessing of having a very thorough and diligent doctor on her case. The nurses in the hematology department have also been very good. My wife is alive today because of the care she has received. When she was diagnosed we had considered going to MD Anderson, but there there were other complications with her case that precluded that option. As it turned out, the right decision was to stay here. We are grateful for both Baptist and UMC.

Anonymous said...

@625am
Very true words. The "Good Ol' Boy n Girl" status quo has been in charger for many years at St Dom. Now with FMOLHS/Baton Rouge looking at their sacred cow "Programs of Excellence" that have been losing millions and (?) lack of statistical improvement in patient longevity...interesting times at St Dom.
The "gold standard" for lumbar/cervical decompression/fusion is "progressive neurologic deficit and spinal instability" which can be documented via exam, nerve conduction study (fixed vs. progressive deficit), and flexion/extension films, with MRI/CT adding to the information, but not a "stand alone" reason to schedule surgery. "Degenerative Disc Disease" is not an indication; "Low Back Pain" is a symptom, not a diagnosis, and is not an indication. Trauma is a different animal and not a part of the JAMA criteria for analysis.
Yup, look around and see how many fusions on the lumbar spine are being done at UMC, Rankin Merit, St Dom, MBMC, River Oaks Merit, CMMC Merit, etc....and why does Workers' Compensation assign a greater impairment rating for a WC claimant/patient once they've had a fusion...if it's supposed to treat/improve their functional status, but makes it worse?
I don't know if it's still active, but there was an excellent website "Doctor Skeptic", from an astute spine surgeon, making interesting observations on the amount of spinal fusions and the financial incentives driving such operations...keeping hospitals afloat.
Perhaps one of the MD's that has friends at the WSJ needs to get them back down here for another round of articles exposing the underbelly and financial incentives to the "fusion industry".
Hmm...


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