What's Wrong With Healthcare Quality Measures? Part I
In their article in this week's the Journal of the American Medical Association, Robert Panzer, MD, chief quality officer and associate vice president for the University of Rochester Medical Center in Rochester, NY, and colleagues noted that when auditors compared objective clinical findings in the record with the billing code data, "21% of those positive for the claims-based Patient Safety Indicator 'postoperative pulmonary embolus or deep venous thrombosis' were miscoded."
They wrote, "These flaws are expected because claims data are primarily intended to communicate sufficient information for fair payment, not to accurately reflect the nuances of the clinical condition of the patient."
3. The ratings are based on old data.
On the Centers for Medicare & Medicaid Services' Hospital Compare website and many of the above listed rating sites which rely on CMS data, performance periods in some cases began as long as five years ago and ended as long as three or two years ago.
That delay allows hospital officials and front line staff to make excuses for their poor scores, arguing that they're doing it much better now. Of course no one knows for sure, because today's data won't be out for another three or four years.
4. There's too much in the middle.
One thing bugs me about Hospital Compare and a few other rating systems that most folks don't realize. Only 2% or 5% of organizations are "better" or "worse" with everyone else being in the middle, okay. If 90% to 96% percent of all hospitals are the same, why bother measuring?
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