Tuesday, October 17, 2006

New Scorecard

A recent study was done scoring the value and safety of the U.S. healthcare system. The purpose was to develop a scorecard to concretely and regularly evaluate 37 different areas in the system. The US healthcare system scored a meager 66 out of 100 placing it behind countries such as Australia, Canada, Japan, Luxembourg and others on certain measures.

Some praised the scorecard while many others felt we are beating the same drum without offering any solutions. But researchers from the Commonwealth Fund's Commission on a High Performance Health System, which produced the report, said finding a fix for healthcare's chronic and costly flaws was not the point. The scorecard will be updated annually and is designed to give policymakers and the industry a yearly snapshot of the overall performance of the healthcare system.

This scorecard is another attempt to pinpoint and publicize endemic problems that are widely blamed for claiming thousands of lives and wasting billions of dollars. It follows a report by the Institute of Medicine in 1999 that has tallied the cost of medical errors, health disparities, and low-quality, inefficient care.

The 37 indicators include measures such as medication errors, death from preventable disease, unnecessary readmission to nursing homes and disparities among low-income, uninsured or minority patients.

In the report, the U.S. average did not once match the top-performers and the resulting waste and errors added up to $100 billion to the nation's health expenses and claimed as many as 150,000 lives annually.

Some examples in the report showed the U.S. ranked last among six countries for hospitalized patients who reported someone checked prescriptions before they were released. The report also showed doctors regularly prescribe antibiotics for children with a sore throat without running tests for streptococcal bacteria, or strep throat. The US was top among spending.

I do disagree with the statement made by the AHA spokesman. “You can't improve what you can't measure,” said Carmela Coyle, the American Hospital Association's senior vice president of policy. " We have fallen into this trap of trying to document by numbers how we are doing. In the process, we strive to get our numbers up, but miss out on addressing real solutions.

The group expects to release state-by-state scorecards by the end of the year, though data on states isn't as comprehensive.

Using a standard scorecard may help define some key issues, but it will not solve the underlying problems. Joint Commission gives accreditation, but many agree that it does not correlate with quality of care or cost effectiveness.

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