“Would you rather your doctor won the “quality” contest by doing good list management and robust box checking or spent that time listening to you?”

Recently an article in the Wall Street Journal http://online.wsj.com * noted “Quality” has been the buzzword in health care for a decade, but the worthy goal is driving health-care providers to distraction. All stakeholders—insurers, patients, hospital administrators and government watchdogs—are demanding metrics to ensure that money is spent wisely.
Metrics do matter: Pre-operation checklists, hand-washing mandates, length-of-stay goals for inpatient stays, and infection rates for patients with catheters have improved health care in a perceptible way. But holding physicians accountable for specific outcomes or measures of patient compliance ignores the complexity of managing a patient’s care. Metrics are chosen because they are measurable, not because they are proxies for excellence.
Then there’s transparency. Many of these quality measures are part of large contracts between hospital systems and insurers. Large financial payouts depend on meeting certain targets. If a hospital decreases readmission rates by 10%, for example, money gets returned. Individual providers are rewarded with payouts for certain behavior such as printing out “visit summaries” to give to patients, no matter if the information is helpful.”
There are certainly good metrics. “Med reconciliation,” reviewing and updating medication lists when a patient meets with a physician, is well-accepted as a good metric. But many other measures have little bearing on improving patient health.
*to read the full WSJ article, “Why ‘Metrics’ Overload Is Bad Medicine”, by Victoria McEvoy, highlight and click on open hyperlink http://online.wsj.com/news/articles/SB10001424052702303293604579253971350304330
Note: This blog shares general information about understanding and navigating the health care system. For specific medical advice about your own problems, issues and options talk to your personal physician.


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