Go to the Wrong Hospital and You’re 3 Times More Likely to Die
This is so frustrating for me personally - I recently had to choose between several hospitals without knowing anything about the historical patient outcomes for each hospital.<p>A hundred years ago a doctor named Ernest Codman suggested that hospitals should be rated by an &quot;End Result System&quot; [1] where paient outcomes were measured and compared, yet only now do we have the &quot;first comprehensive study comparing how well individual hospitals treated a variety of medical conditions&quot;.  And we still do not know exactly which hospital is best and which is worst.<p>To me the best way to judge a hospital is blindingly obvious: For each patient at admission, estimate the chance he&#x2F;she will be alive after 3 years.  For example, a 65-year-old woman who is a smoker, is overweight and has stage 2 lung cancer might have a 25% chance of being alive in 3 years.  Then compare the predicted outcome with the actual outcome.  For example, say both Hospital A and Hospital B both admit 100 patients with 20% predicted chance of surviving 3 years.  If after 3 years there are 30 such patients from Hospital A still alive but only 10 such patients from Hospital B, it would strongly indicate that Hospital A is better.  We could look then at Hospital A for ways to improve Hospital B.<p>What&#x27;s so disheartening is that this process doesn&#x27;t involve any special technology.  It could have been implemented 100 years ago, albeit with less rigorous statistical methods. We spend a billion dollars on evaluating a drug which has a marginal, one-off benfit for a few hundred thousand people.  But we ignore a process which is cheap and offers long-lasting benefits to millions of people.  It seems that the medical establishment is too powerful in this case.<p>[1] <a href="https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Ernest_Amory_Codman" rel="nofollow">https:&#x2F;&#x2F;en.wikipedia.org&#x2F;wiki&#x2F;Ernest_Amory_Codman</a>