18 de febrer 2013

A new quality measurement paradigm

Quality Measure, Based On Health Outcomes, That Compares Current Care To A Target Level Of Care

The works by David Eddy et al. are a must read always. The latest one at HA February is specially relevant because it represents the introduction of new tools for measuring quality. The abstract says:
The quality of health care is measured today using performance measures that calculate the percentage of people whose health conditions are managed according to specified processes or who meet specified treatment goals. This approach has several limitations. For instance, each measure looks at a particular process, risk factor, or biomarker one by one, and each uses sharp thresholds for defining “success” versus “failure.” We describe a new measure of quality called the Global Outcomes Score (GO Score), which represents the proportion of adverse outcomes expected to be prevented in a population under current levels of care compared to a target level of care, such as 100 percent performance on certain clinical guidelines.
The tool-kit of this Global Outcomes Score is the Archimedes Model. Some months ago I devoted several posts to it. I'm absolutely sure that this approach has wide implications for our health system and I don't understand why we should delay its application. Eddy explains that in several specific situations -mostly population based- more quality represents less costs (-38%!!! p.2446). This is another excellent example of clever budget cuts. Are there any intelligent readers able to apply it? How long will we have to wait for it?

PS. If you don't have access to HA, go through Archimedes webpage.