Using publicly available Hospital Compare and Medicare data, the authors of a recent study in The Milbank Quarterly revealed a considerable range of hospital-level performance on quality, expenditure, and value measures.
The research was based on data for four common reasons for admission — acute myocardial infarction, coronary artery bypass grafting, colectomy and hip replacement surgery. Quality-of-care measures included satisfaction, use of timely and effective care, and avoidance of harms. To measure value, the researchers used a numerator score composed of quality-of-care measures and a denominator composed of risk-adjusted 30-day episode-of-care expenditures.
Ultimately, the study findings demonstrated substantial variation in aggregate measures of quality, cost and value at the hospitals examined. For instance, with the exception of CABG admissions, higher-value hospitals tended to be larger and have a higher average daily census than lower-value hospitals. That said, higher-value hospitals were no more likely to be accredited by the Joint Commission or to have a residency program accredited by the American Council of Graduate Medical Education than lower-value hospitals.
"Transparent data like those we present [in the study] can empower patients to compare hospital performance, make better-informed treatment decisions and decide where to obtain care for particular healthcare problems," the authors concluded.
More articles on measuring quality:
Three criteria to help define metrics in value-based care
Pharmacy & quality metrics: Using data to improve savings and population health
Evidence-based treatment drives benchmarking for continuous outcomes improvement