Most hospitals in Ontario, Canada refuse to be identified in a report measuring the quality and safety of hospital care, according to the Fraser Institute, an independent research and educational organization.

The Hospital Report Card: Ontario 2009 is a peer-reviewed and risk-adjusted study that compares the performance of Ontario's 136 acute care hospitals. The study was released March 12 by the Fraser Institute.

Only 17 hospitals agreed to be named in this year's report, a significant drop from the first report card for Ontario in 2006, when 43 hospitals agreed to be identified.

"By refusing to be identified, Ontario hospital administrators are hiding vital information from Ontario taxpayers and patients about the quality of tax-funded healthcare provided in their community," said Nadeem Esmail, director of health system performance studies at the Fraser Institute and co-author of the report.

"While the hospitals that agreed to be identified in this report should be applauded for their commitment to patients and the public by being accountable and transparent regarding their performance, administrators who refuse to be identified are ducking accountability and hiding behind a wall of silence," Esmail said.

The report card compares the performance of hospitals on up to 50 separate indicators of quality and patient safety. It provides 39 indicators of inpatient quality and patient safety calculated for the latest year for which results are available as well as a Hospital Mortality Index that shows overall performance across nine indicators of mortality.

"If you have a greater chance of dying from a heart attack in one hospital compared to another, or if there was a greater chance of having a foreign object left inside of you following surgery, isn't that something you would want to know? Patients have a right to know how their hospital compares to other hospitals," Esmail said.

The report card also provides information on the various indicators of inpatient quality and patient safety for municipalities (based on where patients lived).

Esmail cautioned that since patients move between municipalities, a municipality's ranking does not equate to the ranking of its hospital. This means the highest or lowest performing municipality is not necessarily home to the best or worst performing hospital.