The Centers for Medicare and Medicaid Services is taking an unprecedented step in advertising its Hospital Compare Web site, taking out advertisements in all 50 states, including one locally that lets people see how quality was ranked at local medical facilities.

The $1.9 million campaign shows how more than 1.1 million patients nationwide rated more than 2,500 hospitals. The Hawai'i ad shows the results for nine hospitals locally in terms of people who received antibiotics one hour before surgery, something that reduces risk of infection.

It also shows what percentage of patients responded positively to a question about receiving help at the hospital when they wanted it.

The federal agency has operated www.hospitalcompare.hhs.gov since April 2005, along with a companion site, Nursing Home Compare, to help people research where to get healthcare. Quality measures for 17 hospitals in Hawai'i and 46 nursing homes locally are available on the sites.

"This is another tool for helping people make better choices about their healthcare," said CMS spokesman Jack Cheevers.

It also is in keeping with a larger goal of the agency to help improve the quality of healthcare. Cheevers said the report cards will provide an impetus for some hospitals to improve their status. The Hospital Compare site allows people to check on hospital performance in a variety of situations, including heart attacks, pneumonia and surgical care.

An increasing number of people are using the Internet to research health issues. Three years ago the Pew Internet & American Life Project reported eight in 10 Internet users had looked for health information online.

Others that are providing information include search service giant Google Inc., which earlier this week launched Google Health.

Besides allowing users to store and manage their health records online, Google Health will feature information from HealthGrades. Users will be able to use Google Health's "Find a Doctor" feature to get quality information for 5,000 hospitals and 700,000 physicians nationwide.

Users need to sign up for Google Health and then can perform searches.

For example, a search for a cardiologist in Honolulu on Google Health turns up about 200 results, some of which include reviews from HealthGrades and others.