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Hospital Performance Measures Need Improvement

A new study suggests that hospital performance measures do not necessarily convey reliable, meaningful information, making it difficult for consumers to make sound healthcare choices.

The article, published in last week’s Journal of the American Medical Association, found that hospital performance reports focus primarily on protocols and guidelines but lack certain important information – such as outcomes and survival rates.

Dr. Harlan M. Krumholz, co-author of the study and professor of medicine at Yale University, said that survival rates may vary among hospitals even in cases where standard protocols are adhered to.

For instance, despite standard care protocols for heart attack patients, survival rates may vary because of other factors that are not typically evaluated such as elapsed time in responding to the emergency, the rate of medical errors, and hospital staffing issues.

One solution, according to Krumholz and his co-authors, is for hospitals to include 30-day mortality rates in their performance reports.

“I think it’s important to include an overall summary, such as survival,” said Dr. Krumholz.

Currently, hospitals are required to report only certain data on “core” categories of care, which are considered to be indicators of quality treatment. The Centers for Medicare & Medicaid together with the Joint Commission on Accreditation of Healthcare Organizations monitor the data.

Dr. Ashish K. Jha, an assistant professor of health policy and management at the Harvard School of Public Health, said that hospital performance measures are crucial to providing high-quality health care.

“More information is needed on processes and outcomes across a large number of conditions for hospitals, physician practices, and other health care settings and practitioners,” he said.

The goal, said Krumholz, is to put valuable hospital and physician information into the hands of consumers.

“It starts the conversation about quality. People start talking. Doctors start talking. Payers start rewarding hospitals that provide this information. There are ways to put pressure on the system so they have to improve quality,” he said.

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