Are Hospital Quality Measures Any Good?
The nation’s best hospitals are getting the worst scores:
The Cleveland Clinic, Mount Sinai Hospital in New York City, Geisinger Medical Center in Danville, Pa., and Massachusetts General Hospital in Boston were among those places having substantially more complications than the average hospital, according to data evaluated by the Medicare program. Major teaching hospitals were nearly 10 times as likely as other hospitals to be rated as having high rates of serious complications, a Kaiser Health News analysis of the data shows…
Officials at many of the hospitals listed as having high rates of complications say the measures are distorted in ways that exaggerate problems at hospitals that treat lots of complicated cases or very sick patients.
Source: Kaiser Health News
Answer: probably not.
I’m very hard on hospitals, but I agree that these measures are unfairly biased against hospitals which take on “difficult cases.”
If such quality measures were used to determine reimbursements, it would discourage hospitals from treating the difficult cases.
By this measure, some of the horrendous, community hospitals probably look stellar by comparison given that that nobody would patronize them for a serious illness.
What better way to impose rationing without alarming the public that that is what is going on?
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These teaching hospitals are much more logistically complex. More people seeing the same patient, residents coming and going, conflicting needs for limited resources, etc…. This complexity is a natural breeding ground for infections, falls and other lapses in care.
Patient acuity is a consideration but likely not the main reason for the dramatic different in core measure outcomes.