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Birth of a Ranking: Which Hospitals Are Best at Delivering Babies?
Tweet Share on Facebook November 16, 2012 CommentMost of the roughly 4 million babies born in the U.S. each year are delivered in hospitals, the vast majority without significant incident to the infant. But hospital choice matters. Depending on her choice of hospital and, of course, provider, an expectant mother may be much more or less likely to undergo induction of labor, surgery, or other interventions intended to assist delivery and ensure a healthy child.
Her providers, moreover, may include a midwife (or not) and may be highly experienced—or not. They may or may not have a specialists in neonatal care at their disposal, if need for such expertise arises. These and other differences among hospitals might affect the costs and medical consequences of delivery, even one that produces a healthy infant.
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Doctor Referrals: A Foundation for Evaluating Performance?
Tweet Share on Facebook November 15, 2012 CommentCould a doctor's professional network—the pattern of referrals to and from other doctors—say something important about the quality of care he gives his patients? Health IT expert Fred Trotter thinks so, and he's been amassing data to see whether he's right. Does a primary care doctor choose wisely when he is referring patients for complex care, or does he send some of them to a colleague with a record of medical or ethical lapses? Does a specialist handle mostly routine referrals from local colleagues, or is she a superspecialist to whom doctors refer their most challenging patients?
Trotter, author of Hacking Healthcare: A Guide to Standards, Workflows and Meaningful Use (O'Reilly Media), believes that referrals at least suggest the level of care the doctor provides, if not a precise measure of quality. He readily acknowledges that even if he's right, referral patterns fall short of hard data that would allow every doctor's performance to be evaluated. "I've been looking for an objective way to rank doctors for a long time," he says.
