June 16, 2015 – Gaming the System

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Anchor lead:  Can safety and quality data in healthcare reveal flaws in the system? Elizabeth Tracey reports

How easily can outcome measures for healthcare be overcome so results look better than they are?  Fairly easily, as one surgeon revealed recently in a letter on how mortality data can be manipulated.  Matt Austin, a quality and safety expert at Johns Hopkins, says this is a work in progress.

Austin: Performance measurement in healthcare is actually still in its infancy, we’re really still trying to develop the science of how best to measure quality and safety, and no measure is perfect and no measure will ever be perfect but hopefully we can address those kinds of issues by having balancing measures, so you might look at length of stay as a balance to mortality. A good performance might be a hospital that has a low 30 day mortality rate and also has a length of stay that’s within some sort of normal range.   :31

Austin says if you’re using such data to make healthcare decisions, ask questions and probe a bit.  At Johns Hopkins, I’m Elizabeth Tracey.