Never mind this website comparing schools. Health economist Gavin Mooney has been toying with some ideas for other useful new websites. He writes:
“My Hospital enables you to search the profiles of Australian hospitals. My Hospital is a government backed information service provided by an independent authority with functions including the publishing of nationally comparable data on all Australian hospitals. This responsibility is derived from the Hospitals Act and through the decisions of the Ministerial Council for Health.
The information on this site has been provided by individual hospitals and health authorities.
The performance of hospitals is greatly affected by a range of patient intake and hospital location characteristics. When comparing hospitals, it is important to compare like with like. The My Hospital website allows and encourages comparisons with hospitals that are statistically similar in terms of a range of factors known to affect clinical performance.
This site is thus aimed at assisting patients to choose between hospitals. It uses an index of disadvantage to reflect social determinants of health. This allows people who are poor to compare themselves in terms of their health and their hospitals with other people who are poor. Similarly, rich people can compare themselves with rich people.
A word of caution. The site has not been designed to allow comparisons between the health of the rich and the health of the poor. That issue is, for the government, not something we want people to think about. Be assured your government is not ignorant of the work of Johnny Wilkinson and Michael Marmite.
To have people thinking seriously however about the health disparities between rich and poor would risk creating a lot of bad feeling towards the government and this is a government that believes in risk management. Further, thinking about such disparities might actually make people sick. (If you do want to think that you are thinking strategically about health, please do not use this site but instead go to the Intergenerational Report and join us in the distraction we have created there about aging and health care in 2050. Getting you to think about that has the advantage for us that by 2050 we will have been out of government for decades and will not be able to be held responsible for whatever happens at that time.)
Another word of caution. The data presented here relate only to those available and measureable, such as deaths, lengths of stay, etc. Just as good citizenship is clearly a non-measurable outcome of schools (see myschool.edu.au), so friendliness of staff, respect for patient autonomy, equity in health care delivery, etc. are non-measureable outcomes of hospitals. We do not think you should worry about these ‘other’ things. They are mere distractions.
And yet another word of caution. We recognise that there is more to health and health care than hospitals, such as a safe home environment, primary health care and community support (just as in education the home environment, other social services, etc. can make a difference to educational attainment) and that these factors vary markedly between families and geographical locations. But we are not in the business of wasting infinite resources (but only large sums of tax payers’ money) on trying to get this right. We think what we have presented here is good enough for us. We leave it to you to decide whether it is good enough for you.
And still another word of caution. You may have heard of evidence based medicine (EBM) which is aimed at showing what the best interventions are in medicine. EBM examines, for as near as possible identical patients with the same diagnosis and severity etc., whether one clinical treatment adds more health than some other clinical treatment. This approach to medicine is often supported by what are called ‘randomised controlled trials’.
Please do not assume that this is the philosophy behind myhospital.com.au. It is not. What we are doing is different. We are not comparing hospitals in a way that can be justified logically and we are not looking at ‘value added’. The idea instead is simply to look at what comes out of hospitals (and certainly not what goes in) and to do so on the basis of some rather limited outcomes but, crucially, measureable ones. We are not in the business of worrying about whether patients feel more cared for in one hospital than in another. That is not measureable, so why bother.
Welcome to this important aid to choosing between hospitals. We wish you a happy hospital stay – wherever that may be.
Please note that your government really thinks it is on to something big with these new information websites. We shall continue to roll them out at great expense perhaps to enlighten you but more likely to confuse.
The next site to go up will be Myprison.com.au which will provide information on available measureable outcomes (such as chances of escaping) to allow potential consumers to make more informed choices regarding where they want to be incarcerated. The site planned beyond that is aimed at potential asylum seekers – Myboat.com.au (but for reasons of national security we cannot reveal what sort of information might be on that site). For more information generally about these sites go to Myspace.com.au…”
• Gavin Mooney is Honorary Professor, University of Sydney.