What makes a hospital shine?To the Forum:

As a retired anesthesiologist of some 40 years, people ask me how or why Wilcox

Memorial Hospital became one of the 100 best hospitals in the United

States.

I worked for 33 years in another hospital on the list, Baystate

Medical Center in Springfield, Mass. That hospital has in excess of 900 beds,

nine times larger than Wilcox, is a branch of Tufts University Medical School,

is a teaching hospital with cardiac surgery, neurosurgery, and performs

transplants.

It is certified by the JCHA (Joint Commission of Hospital

Accreditation), the standard for hospital excellence. The top 100 listing is

produced by Health Care Investment Analysts (HCIA).

Wilcox is listed in the

top 20 of the 100 lists, those with 25-99 beds. The total number of 100 top

hospitals is divided into five classes, i.e. hospitals with 25-99 beds, medium

size hospitals, large community hospitals and teaching hospitals, 20 hospitals

in each group.

It should be obvious that hospitals in the 25-99 bed size

do not have the staff, equipment and wherewithal of the large community

hospitals and teaching hospitals.

The HCIA report identifies industry

benchmarks by recognizing hospitals and their management teams that demonstrate

superior operational and financial performance.

Obviously, of the top 100

hospitals, it is like comparing apples and oranges when you compare the less

than 100-bed Wilcox Memorial with one such as Brigham and Women’s in Boston or

Baystate Medical Center in Springfield, Mass., all of which are in the “Top

100″ list.

It should be stated clearly that there are some excellent

doctors on the staff of Wilcox Memorial.

Cardiologist Harlan Krumholy of

the Yale School of Medicine, who published an analysis of the HCIA listing,

says individual cases vary too much for ratings to affect patient decisions. He

complains that HCIA focuses too intensely on the bottom line, rewarding

hospitals that cut costs but don’t deliver better care.

A study was

published this year in the journal, “Health Affairs,” analyzing the HCIA’s top

100 list of cardiac facilities and found that patients fared no better at the

listed facilities than at other heart centers—only their insurance companies

got off easier with a stay at the listed hospital, he said, because of lower

costs.

Further information may be found on HCIA.com.

Ray T. Smith,

MD

Princeville

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