Fox Chase Cancer Center's website to tout mortality data

 Doreen Benedict sought treatment for her breast cancer at Fox Chase Cancer Center, more than an hour from her home in Mount Laurel, based on the recommendation of a friend.

While the Northeast Philadelphia hospital is happy to get such word-of-mouth publicity, starting Monday it wants prospective patients to know about an even more concrete source of information:

Hard numbers on its website.

Fox Chase is posting graphs that indicate how many of its patients were alive five years after treatment for four common cancers: breast, prostate, lung, and colorectal.

The numbers, for cases diagnosed between 1998 and 2002, are compared with those from large and medium-size community hospitals - though not with other research institutions like Fox Chase. Patients at Fox Chase fared better in almost every category, according to the data, which the hospital said had been taken from the National Cancer Data Base, maintained by the American College of Surgeons.

The move is a part of a trend toward grading health-care providers on performance, though most efforts are the work of third parties and not the hospitals.

The theory is that patients will go where they have the best chance of success, though studies have found this is often not the case. Historically, many patients have relied on such factors as the advice of a primary doctor or whether the hospital is close to home.

But as with most things, change has arrived courtesy of the Internet, said John Birkmeyer, director of the University of Michigan's Center for Healthcare Outcomes and Policy.

"People use the Internet to track down not only where to get the best meals, but also health care," he said. "I can't tell you the proportion of patients that see me who know where I went to medical school and other tidbits about my professional life."

The Fox Chase website, at www.foxchase.org/outcomes, includes separate graphs for the four stages of each cancer. In some cases, its patient survival rates are not that much better than those at the other hospitals, but sometimes the difference is dramatic.

More than 65 percent of Fox Chase patients with stage-four prostate cancer were alive after five years, for example. About 40 percent were alive after treatment at the large community hospitals, and fewer than 35 percent survived at the medium-size facilities.

Asked why the website does not include a comparison with other elite cancer research centers, hospital chief executive officer Michael V. Seiden said Fox Chase's results were "very similar" to those of its peers.

For some cancers Fox Chase's performance was a bit better than the other elite facilities, for others a tad worse, Seiden said.

"We didn't feel it was fair to make a big deal of either one of those," he said.

At the two other high-profile cancer centers in the city - the Abramson Cancer Center of the University of Pennsylvania and the Kimmel Cancer Center at Thomas Jefferson University Hospital - officials said Friday that they were not immediately able to provide data like those on the Fox Chase site.

Other hospitals that have gone public with performance data include the Vanderbilt-Ingram Cancer Center in Tennessee and the Cleveland Clinic.

Seiden attributed Fox Chase's performance to its involvement with cutting-edge research and technology and to its high volume of cases. Indeed, studies have found that for various kinds of serious illnesses, patients are better off when treated by a provider with a lot of experience.

Expertise is part of what drew Benedict, 71, the breast-cancer patient from Mount Laurel. She got the initial recommendation from a friend who had prostate cancer, and was further impressed that Fox Chase focuses exclusively on cancer.

It was a long drive to get the chemotherapy and radiation treatments, especially when they left Benedict feeling sick.

"There were many days when I said, 'No, I'm not going,' and my husband said, 'Get your coat on,' " she recalled. "I'm very glad that I did go there."

Another reason that high-caliber research institutions such as Fox Chase have better outcomes is that the patients who seek them out tend to have a higher socio-economic status, said Michigan's Birkmeyer. Studies find that such patients tend to fare better independent of where they are treated, he said.

Birkmeyer said he expected more high-end hospitals to publish their data, but not just to attract patients.

Such facilities tend to have higher prices than neighborhood hospitals, and costs are under scrutiny as part of the overhaul of the health-care system, he said.

"There's a stronger pressure to justify their higher prices," Birkmeyer said.

Seiden, the Fox Chase CEO, said he did not know how the hospital's prices stacked up, because it is illegal for facilities to share such information. Yet he acknowledged that the new health-care law was a consideration as the idea for the new website was developed.

"I think all of us have to justify that we deliver high-quality health care," Seiden said, "and I think this is one way to try to demonstrate that."