
Tussles on the Healthcare Quality Data Battleground
Today has been a tough in the world of healthcare quality metrics. Physicians suffering from a lack of patient accountability, hospitals are being judged unfairly by a biased metric and their own reputations, cats and dogs living together...mass hysteria!
Today has been a tough in the world of healthcare quality metrics.
First, US New and World Report's
Finally, a physicians are denouncing a new rating system
Reputation trumps all
Seeking to "quantify the role of reputation in determining the relative standings of the top 50 hospitals in the 2009 edition of US News & World Report's rankings,"
Though Seghal concludes that "little relationship exists between subjective reputation and objective measures of hospital quality among the top 50 hospitals," Avery Comarow, US News & World Report's health rankings editor, believes that this is a philosophical difference between Dr. Seghal and the news magazine.
More bluntly,
When we said you failed, we might have made a slight error...
According to
The path of least resistance, though, is not usually the most effective. Pronovost and Lilford claim that hospitals should be judged only by the number of preventable deaths that occur within their walls, while the inpatient mortality rate considers all deaths. Pronovost and Lilford, for example, say that rates of death after elective procedures or from blood stream infections are effective yardsticks.
Where's my blue ribbon?
Meanwhile, California physicians are protesting the
"The organizations worked together to measure the performance of 13,000 high-volume physicians on evidence-based healthcare quality standards" and "will publicly recognize physicians who scored above average in up to eight measures in preventive screening, diabetes, and other categories.
The effort is all well and good,
At issue is the fact that the CPPI "relies solely on claims data" which the CMA claims "fails to comprehensively document the care a patient receives or the reasons a patient may not receive the care that is the focus of a quality measure." Further, they feel that the awarding of digital blue ribbons to physicians that score in the top 50th percentile will imply that those without ribbons are not "quality doctors," which could hurt their practices.
CMA claims that it has been working for more than two years to try to address its concerns, but to no avail, hence the groups withdrawal from the initiative. In that case, it seems that none of the parties will be able to agree on anything, so, rather than dwell on the institutional back and forth, it's probably best to wait and see how the initiative plays out with the Blue Cross insured.
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