The Fraser Institute

The Fraser Institute

June 18, 2009 08:00 ET

The Fraser Institute: Alberta Health Services Won't Tell You Which Hospitals Are Best or Worst, Improving or Declining

CALGARY, ALBERTA--(Marketwire - June 18, 2009) - One Alberta hospital has an injury rate for newborns more than four times the provincial average. Patients in another Alberta hospital are five times as likely to pick up an infection following medical care, while patients at yet another hospital are more than twice as likely to experience bed sores.

The performance of Alberta's hospitals is detailed in a new report from independent research organization the Fraser Institute. The Hospital Report Card: Alberta 2009 measures the performance of all 102 acute-care hospitals in Alberta across 39 indicators of inpatient quality and patient safety based on data from 2002 to 2007. The report also includes a Hospital Mortality Index measuring hospital performance across nine mortality indicators.

But the report is unable to provide the names of specific hospitals because Alberta Health Services refused to release hospital names.

"If I want to buy a car, I can go on the internet and get all kinds of information about quality, safety, and reliability, and even ratings and comments from experts and other customers. The same holds true for everything from vacation resorts to restaurants. But when it comes to the quality and safety of services provided by Alberta hospitals, a cone of silence descends," said Nadeem Esmail, Fraser Institute director of health system performance studies and co-author of the Hospital Report Card: Alberta 2009.

"By failing to allow hospital performances to be objectively measured and reported, the Alberta government is refusing to commit to accountability and transparency, something I'm sure most Albertans will find unacceptable."

This peer-reviewed study provides the first detailed, objective, and independent assessment of Alberta's hospitals using an internationally accepted methodology. The study examined more than 1.7 million completely anonymous patient records from the Canadian Institute for Health Information's (CIHI) Discharge Abstract Database. This information is derived from patient records provided to CIHI by all hospitals in Alberta. All of the information in the hospital report card is available at or on the interactive website

Since specialized hospitals may treat more high-risk patients and some patients arrive at hospitals sicker than others, the indicators in the Fraser Institute's hospital report card are risk-adjusted to account for differences in health status among patients.

Some of the other measures tracked in the report card include the number of incidents of respiratory failure following surgery, number of accidental cuts or wounds during a procedure, the number of incidents when a foreign object was left in a patient during surgery, number of incidents where a physician inadvertently collapsed a patient's lung, number of deaths following hip replacement surgery, deaths among patients who developed complications during hospitalization, and the rate of caesarian births.

"If there's a greater chance of being seriously injured, acquiring an infection, or dying in a hospital, isn't that something you would want to know?" Esmail asked. "Surely both parents-to-be and hospital administrators would benefit from knowing which hospital experienced the higher rate of injuries to newborns to ensure that our youngest Albertans are not being put at undue risk of harm."

The report card's 39 indicators of inpatient quality and patient safety are also calculated for Alberta's municipalities (based on patient residence information). Using the index of nine mortality indicators, Ponoka and Fort Saskatchewan had the best rankings among municipalities, with scores of 86.9 and 85.2 out of 100 for 2005-2007. The lowest ranked municipality was Camrose at 68.1 followed by Sylvan Lake with 70.0 then Cochrane and Lethbridge, each at 78.7.

Because patients move around the province of Alberta however, it cannot be automatically assumed that the hospital in the highest ranked municipality is also the highest ranked hospital.

"It's unfortunate that Alberta Health Services has chosen to hide behind a wall of anonymity. Their actions stand in stark contrast to the government of British Columbia, which released the names of all hospitals for the Institute's BC hospital report card in May, allowing British Columbians to make more informed decisions about their health care based on valid and accurate indicators of the quality and safety of in-hospital care," Esmail said.

"If we are going to seriously work towards improving Alberta's health care system, the provincial government, bureaucrats, and health care workers must accept the need for measurement and comparison while acknowledging the rights of health care funders and users to know how the system is performing."

The Fraser Institute is an independent research and educational organization with offices across North America and partnerships in more than 70 countries. Its mission is to measure, study, and communicate the impact of competitive markets and government intervention on the welfare of individuals. To protect the Institute's independence, it does not accept grants from governments or contracts for research. Visit

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