RESUMEN
External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs.
Asunto(s)
Cultura Organizacional , Garantía de la Calidad de Atención de Salud/métodos , Mejoramiento de la Calidad/normas , Indicadores de Calidad de la Atención de Salud , Medicina Basada en la Evidencia , Costos de la Atención en Salud , Hospitales/normas , Humanos , Errores Médicos/prevención & control , Política Organizacional , Desarrollo de Programa , Indicadores de Calidad de la Atención de Salud/economía , Estados UnidosRESUMEN
Healthcare costs are unsustainable. The authors propose a solution to control costs without rationing (deliberate withholding of effective care) or payment reductions to doctors and hospitals. Three physician-led strategies comprise this solution: reduce (1) overuse of health services, (2) preventable complications and (3) waste within healthcare processes. These challenges know no borders.