It's a compelling vision of a new day in health care: Armed with data about hospital quality and cost of care, patients will be able to make informed decisions about where to go for surgery or hospital care. Over time, the market force of thousands of well-informed patients making smart decisions will force reform on medical institutions that charge too much or perform poorly.

But in reality, it doesn't work like that and probably never will.

Most of the time, it is a patient's doctor who decides where the patient will be treated, often with the consent of the patient's insurance plan, which has to pay most of the bills. Patients are steered into the hospitals where their surgeon or medical specialist practices, and to switch hospitals, a patient usually has to switch physicians as well. Few are able or willing to do so.

However, recent efforts to compile data on hospital cost and quality —- and to make that information publicly available online —- are still useful and productive. They may not transform the health care industry, but they do have the potential to inspire more meaningful conversations between patients and their health care providers about where to get the care that patients need.

The data are slowly becoming available in a variety of forms, including Web sites offered through the Georgia Hospital Association and state agencies such as the Georgia Department of Community Health. The best of the sites —- www.hospitalcompare .hhs.gov —- compiles information from Medicare data banks and patient surveys. It marks the most significant effort yet to get hospital quality and cost information into consumer hands. Federal officials and consumer advocates hope the availability of those surveys will spur hospitals to improve patient care.

Until now, access to such information has been extremely limited. Hospital officials have been reluctant to release some cost information, claiming the data could be misinterpreted and should not be used to compare one hospital to another.

They make a valid point. Such comparisons can indeed be misleading because the numbers often are not adjusted to account for such things as the severity of illness or the age of the patient. That helps to explain why the charge for coronary bypass surgery at Grady Memorial Hospital, the state's largest public hospital in Atlanta, is a lot more ($31,389) than at the private St. Joseph's Hospital in Sandy Springs ($19,321). Grady patients tend to be poorer, older and sicker than those treated at St. Joseph's. (These charges reflect only what Medicare paid the hospital for such care, not what it paid the physicians who treated the patients.)

So far, the available information also does not allow comparisons of patient "outcomes" —- whether they live or die, whether they get an infection while hospitalized or if a medication error is made.

However, the federal Web site does contain patient satisfaction surveys that detail, among other things, how well a hospital did in controlling patient pain, how well its employees explained how the drugs they were being prescribed were supposed to work, and even whether the hospital was quiet at night.

That can be useful information for patients facing surgery or hospitalization, and patients should use it when consulting with their physician about where they will be treated. And if their doctor isn't responsive to their concerns, they should if possible be prepared to switch doctors as well.

—- Mike King, for the editorial board (mking@ajc.com)