Hawai'i hospitals performed poorly when compared to counterparts in most other states, a new study concluded.

The report by Evanston, Ill., healthcare researcher Solucient placed Hawai'i in the bottom 20 percent of all states.

The report did not break out ratings for the 14 major Hawai'i hospitals it studied, but "when you take them as a whole across the measures, the (Hawai'i) hospitals do not perform ... as do other states," said Solucient Senior Vice President Jean Chenoweth.

"It does not at all mean that there aren't good hospitals in Hawai'i," Chenoweth added.

In years past, Solucient has cited Hawai'i hospitals for excellence. Wilcox Memorial Hospital on Kaua'i was listed as one of the nation's top 100 hospitals in 1999, while Straub Clinic & Hospital was tabbed as a top 100 cardiovascular hospital in 2000.

Local healthcare officials, including state Department of Health Director Dr. Chiyome L. Fukino and Rich Meiers, head of the Healthcare Association of Hawaii, said they were still looking at the Solucient report and weren't prepared to comment. Officials from Hawaii Pacific Health and The Queen's Medical Center did not have immediate comment.

Categories analyzed by Solucient included risk-adjusted mortality, patient safety, risk-adjusted complications, profit from operations and cash-to-debt ratio.

The study, released earlier this month, excluded hospitals with fewer than 26 beds, specialty and pediatric hospitals and veterans hospitals. That meant a dozen hospitals in Hawai'i weren't included in Solucient's analysis.

Chenoweth said the results are meant to help hospital executives and boards of directors see where they stand in relation to national measures.

The Solucient study differs from others in that it measures both clinical and financial performance. The reports are geared toward giving hospital executives an idea of how they're doing.

Chenoweth was author of the study that broke state performance into five different performance levels. Hawai'i and six other states "remained mired" in the bottom grouping in the 2004 and the recently released 2006 report, Solucient said.

Solucient's study and other healthcare scorecards are part of a trend toward more information becoming available publicly about hospitals, physicians and other medical care.

The U.S. Department of Health and Human Services in April 2005 opened its Hospital Compare Web site, allowing people to check on hospital performance in heart attacks, heart failure, pneumonia and surgical care.

Another research company, Health Grades Inc., started up in 1999 to offer hospital-quality information. Other companies such as Flagship Global Health identify and provide access to a network of top medical specialists for a fee.

Rick Wade, senior vice president for the American Hospital Association, said none of the studies should be taken alone and that consumers shouldn't use a single one to make a decision on healthcare. He said some of the available information can be used to draw up questions for doctors.

Moreover, consumers need to remember the data underneath the analysis is probably several years old and that things could have changed.

"It's a snapshot in time," Wade said. "It might not necessarily describe institutional performance today."

Health Grades said that Pali Momi and Kuakini Medical Center are in the top 10 percent of hospitals nationwide in terms of joint replacement surgery, while Queen's is in the top tier when it comes to orthopedic care.

Straub Clinic and Hospital is included in Health Grades' top hospitals for strokes.

"There are certainly some bright spots to be found in Hawai'i," said Health Grades spokesman Scott Shapiro.

But as a whole, Hawai'i hospitals didn't fare well in a Health Grades' 2006 patient safety study.

LOW ON PATIENT SAFETY

Health Grades ranked Hawai'i 43rd in the study that analyzed patient safety indicators. That put Hawai'i among 10 states and the District of Columbia in the "performed worse than expected" category.

A check of the U.S. Department of Health and Human Services' hospital comparison Web site shows that while individual Hawai'i hospitals rank above national averages in some categories, the group as a whole is three times more likely to score below average than above average when it comes to 21 medical processes.

The Department of Health and Human Services' Hospital Compare site was created with the help of the Hospital Quality Alliance, a group made up of the American Hospital Association and healthcare organizations. The alliance was created in late 2002 to encourage hospitals to voluntarily collect and report quality performance information.

"The pressure for usable information is out there," said Wade of the American Hospital Association. There are more rankings, including an annual issue by U.S. News & World Report listing top U.S. hospitals and another from the American College of Emergency Physicians, he said.

No Hawai'i hospitals were on the most recent U.S. News best hospital listing.

Last year, the emergency physicians released a study ranking Hawai'i 34th in emergency medicine. The group said Hawai'i had problems with a hospital space shortage and needed more trained professionals.

GREATER SCRUTINY

Solucient's Chenoweth says hospitals are increasingly being judged on a national basis. Hawai'i hospitals may fall prey to comparing themselves only against each other, she said. That is something she sees in other states that are also in the lower tiers.

But with more companies such as hers making national comparisons, hospitals are under greater scrutiny.

"It doesn't mean the hospitals are bad," she said. "The hospitals are used to keeping up with one another. Now they're going to have new challenges, and everyone benefits."

Reach Greg Wiles at gwiles@honoluluadvertiser.com.