Some “quality” awards are based on rather shaky ground. And the Mercury Awards, which used to be handed out by HCIA (now Solucient) appear to fit that category.
According to the website for the North Ohio Heart Center (a cardiology practice in Elyria Ohio), “EMH Regional Medical Center had the top score for quality of care in Cardiology. According to the award, “It had the lowest complication rate and the most efficient length of stay. Its Patient Services score was boosted by its staff ratio and broad offering of cardiac services.”
That’s great, and if you were looking for a place to get your ticker checked, this impressive award may influence your decision. But the basis for the award should get anyone thinking, and at the very least asking a few pointed questions.
For example, the center had “the lowest complication rate”. That could be because the cardiologists are really great. Or it could be because they perform a lot of procedures on low risk patients , patients that are likely to require relatively short lengths of stay and experience low complication rates.
Evidence indicates that the latter may be reality. In fact, compared to national averages, there are four times as many angioplasties performed by the docs at EMH than in the rest of the country. More procedures = more experienced docs; more experienced docs doing procedures on low risk patients = good outcome scores, lower complication rates, shorter lengths of stay.
This looks more like an award for doing too many procedures including procedures on patients that may not have needed them in the first place, resulting in lots of income for both the docs and the hospital.
And the money ain’t bad either. (reg. req.)
Aug
28
I have been harping on that point in numerous comments on other blogs for a long time.
Until you can quantify patient condition, quantifying physician performance is worthless.
In the end all that P4P will accomplish will be to make doctors and surgeons be more selective as to the patients they treat, making mediocre doctors look good, and never really knowing who the best doctors are.
But Marc, if you can’t quantify patient condition, how would doctors be more selective on which patients they treat?
So we’ve established that it’s possible to do it, you just have to figure out a way to do it. The Doctors themselves would probably be able to, but they’d be the foxes guarding the henhouse. (oh, yes this very healthy 42-year old with mild indigestion was a very difficult heart patient to treat).