Where the information comes from

We created the Texas Hospital Checkup using information from three sources:

The Texas Health Care Information Council, formed by the 74th Texas Legislature in 1995, collects data from hospitals and health maintenance organizations in Texas and reports on the quality of their performance. The THCIC gathers data regularly from hospitals, ranging from diagnoses to charges for various procedures.

The Texas Hospital Checkup includes THCIC data on hospital performance between April 2001 through March 2002:
Actual vs. expected mortality
Number of procedures done a year
Average length of stay
Average total charges
Average charge per day
Click here to visit the Texas Health Care Information Council web site.

The Leapfrog Group is a coalition of more than 110 public and private employers and health care purchasing organizations. Together, these organizations provide health care benefits to more than 26 million Americans. The Leapfrog Group has worked with medical experts to identify problems with patient safety and medical errors and propose solutions that it believes will improve hospital care.

The Leapfrog Group has identified three patient safety practices that are important to think about when choosing a hospital. The group chose these practices because scientific studies show that they can reduce deaths and injuries from preventable medical mistakes. To improve your chances of getting good care:
Choose a hospital with proven results or lots of experience giving the kind of care you need.
Choose a hospital that staffs its intensive care unit—ICU—with specially trained intensive care doctors. These hospitals tend to have better patient results.
Choose a hospital with a computerized prescription order entry system for doctors to use when they order medications. These systems help prevent medication errors.

The Texas Hospital Checkup includes information from The Leapfrog Group on:

The recommended number of procedures a hospital should do a year to help ensure quality results
Hospital progress in staffing intensive care units with intensive care doctors
Hospital progress on installing a computerized prescription order entry system
Click here to visit the Leapfrog Group web site.



The Centers for Disease Control and Prevention in Atlanta is recognized as the lead federal agency for protecting the health and safety of people at home and abroad. The CDC provides credible information to enhance health decisions and promotes health through strong partnerships. CDC serves as the national focus for disease prevention and control, environmental health, and health promotion and education to improve the health of the people of the United States.

The Texas Hospital Checkup includes information from the CDC on:
The recommended Cesarean section rate


Data limitations

We've tried to make the Texas Hospital Checkup as accurate as possible. We used patient discharge data from the billing records of all acute care hospitals in Texas gathered by the Texas Health Care Information Council.

Billing records provide a lot of information about what each patient was sick with, what procedures were done and whether the patient died. But billing records don't provide other details that could help determine the expected outcome for each patient.

To be fair, we took into account the differences between each hospital's patients-including how sick they were and differences in age and sex. But it's not possible to account for all differences among patients-like smoking, diet and other lifestyle issues. We used the 3M All Patient Refined Diagnosis Related Group™ (APR-DRG™) system to account for how sick patients were and how likely they were to die. We didn't show mortality rates for hospitals that did fewer than 75 of each type of procedure a year because there isn't enough information to calculate a statistically reliable score. Click here for more details on adjustments that account for how sick patients were.

Here are some other things to remember about information on hospital performance:

There are coding differences on billing records between hospitals. Some hospitals code more completely than other hospitals, making it tough to compare all hospitals fairly.
It's sometimes unclear when a condition happens. Billing records can't tell you if a condition was present at admission or if it happened during the hospital stay. For example, a hospital may have a high rate of complications because lots of physicians refer complex cases to it-—or because the hospital's care caused the complications.
It's hard to classify disease accurately. The ICD-9 classification codes contained in the patient record may not be specific enough to adequately characterize a patient's condition, making it difficult to adequately perform risk and severity adjustment.
The billing record doesn't show things that happen after the hospital stay. For example, a patient may have been discharged alive but died two days later.
The information is for a specific period of time-from April 2001 through March 2002. The report is a snapshot of that 12-month time period. Hospitals may be doing a better or worse job now.
Charges shown are the hospital's billed rates. Actual amounts paid may be significantly less due to negotiated rates with payers. Physician charges aren't included.