Lack of attention on complication rate reductions a tragedy: Grattan Institute

Australian hospitals should release information on complication rates so patients can identify gaps between the best and the worst-performing and make more informed decisions, health experts have urged in a new report.

The Grattan Insitute report, All complications should count: Using our data to make hospitals safer, held that one in every nine patients who go into hospital in Australia suffers a complication, and if they stay overnight the figure increases to one in four.

Health program director at the Grattan Institute Stephen Duckett said Australians expect all hospitals to provide high-quality and safe care, but the report reveals that some hospitals achieve much better results than others.

“A patient’s risk of developing a complication varies dramatically depending on which hospital they go to: in some cases, the additional risk of a complication at the worst-performing hospitals can be four times higher than at the best performers,” the report read. “If all hospitals lifted their safety performance to the level of the best 10 per cent of Australian hospitals, the complication rate across the nation would fall by more than a quarter.”

The Grattan Insitute would like to see patients given access to information on complication rates in different hospitals and for different procedures so they and their GP can make better-informed decisions about how and where they are treated. This would also give clinicians and hospitals an opportunity to see how they are performing compared with their peers and learn from the best-performers, the group said.

“At the moment, a veil of secrecy hangs over which hospitals and clinicians have higher rates of complications and which are safety leaders,” the report read. “Hospital safety statistics are collected, but they are kept secret, not just from patients but from doctors and hospitals. This has to change.”

Duckett said the report’s suggested reforms could cut the complication rate in Australian hospitals by more than a quarter.

“It is time to adopt an epidemiological focus – examining broad patterns – and to learn from hospitals and clinicians who achieve low rates of harm. The policy question is not whether we move to addressing all complications, but when,” the Grattan Institute said. “The sooner we set more ambitious targets the better.”

The report recommends:

• All states and territories establish goals for reducing the overall rate of complications in public and private hospitals.
• All states and territories give hospitals and clinicians the ability to interrogate the state hospitals data (without individual patients being able to be identified), so they can see how their performance measures up against the best-performing hospitals and clinicians. All hospitals develop strategies to identify opportunities to improve.
• All states and territories publish reports on excess complications, by specialty and institution (including private hospitals).
• Major private health insurers provide their members with comparative information on complication rates.

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