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.
well said
lovely, i’d like to register mymp.com.au, attendance, contributions to debate, committees and contributions, declarations, donations, speeches and questions.
Check out the My Birth website http://mybirth.com.au – this website was built by myself and another mum.
The Government would not build this website so we had to do it ourselves.
The My Birth website makes perinatal statistical data accessible to Australian women to help them understand their choices during labour and birth. By making the data more publicly accessible, we hope it will also encourage more transparency and discussion about maternity services and the current rates of intervention.
We have taken the relevant data from the publicly available perinatal data reports from across Australia and created a database which people can search using their post code or by state to see the maternity services in their local area and the intervention rates for those maternity services.
Our Federal Government is making pivotal decisions about how every Australian child will be born in the future. We need to look at the data to help make the best decisions possible. Ideally we would like to see all Australian maternity service providers making their statistics public and transparent, including obstetricians. As many of these services are funded by the taxpayer with millions of dollars of public money each year we feel this information should be easily accessible and freely available to the public.
If Australian parents have the right to know the performance statistics of where their child will be educated, then they must also have the right to know the statistics of where that child is born, and what alternatives are available to them.
Michelle Meares – My Birth
Interesting that Gavin presents myhospital.com.au just a week after an article was published in The Age (28 January 2010) “Plan for national hospital monitor” suggesting that bureaucrats were engaged in a $4 billion proposal to monitor and scrutinise Australia’s hospitals with the Federal Minister declining to comment.
For those of us who perhaps have been around too long the evidence on performance and outcomes is obvious and well known. Inner city teaching hospitals consume the greater proportion of resources, outer urban city hospitals generally have much less resources for the same population, but much needier communities and by the time we get to rural and Aboriginal communities the equation is bleaker.The resource allocation also generally reflects health status and outcomes(or lack of). Perhaps this is the same issue for the my.school.com.au where any indicator of dollars invested per child and how that is allocated geographically and its relevance to effectiveness is strangely absent!
In both Schools and in hospitals in most States they are directly funded, managed and services are delivered by State bureaucracies. So, in reality the ‘Commonwealth State body’ to be created to oversee hospitals will be examining its own performance. Hospitals can only operate within and to the extent of State allocated funds and have little local authority or capacity to manage in their own right.
The evolution of large State controlled health systems has occurred with little public debate or evaluation of effectiveness. The approach is not consistent with the historical, political or cultural context of health care in Australia. Increasingly these highly systemic approaches have failed if formal public Inquiries are taken as a measure of failure. Generally health professionals and communities have been disengaged from any governance or decision making about what communities need and want in terms of health care.
Until a re-engagement of communities and health professionals in governance of their health system is re-established and management and organisational scale is returned to proportions that allow diversity, engagement and innovation in health care organisation and delivery we will continue on an ineffective path to further tight centralised bureaucratic control.
I would love the alleged $4 Billion to develop this watchdog to be better used by committed communities and health professionals to demonstrate how they could reshape and make more effective the health care of our communities. The debate on hospitals and performance ahead of effectiveness, that is the outcomes of care, is highjacking the health care debate and I am not looking forward to sitting in awe and amazement of charts and graphs about what is already substantially known. Maybe some of the outcome measures might assist but also need to identify resource use. Lets keep some of the $4 billion for effective health care reform and let communities and committed health professionals demonstrate what they are capable of achieving.
Dr. David Briggs is Co-ordinator of Health Management Programs at the University of New England and Editor of the Asia Pacific Journal of Health Management.
Myhospital, myschool and myjob. Myjob like myhospital is supported by MyJulia. Fair choices for a fair days work. You can go on the web site and compare your jod work agreements with other similar job agreements. You can ask people to join your myjob face book and compare levels, discuss bargaining agreements and how to negotiate ways to meet expectations.