March 27, 2015 – Outcome Measures

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Anchor lead:  How should you compare doctors and hospitals?  Elizabeth Tracey reports

Do physicians game the system when measures such as 30 day mortality are used to grade their performance, as a recent report suggests?  Joseph Califano, a head and neck surgeon at Johns Hopkins, says such an outcome is certainly possible.

Califano: There are a whole lot of measures out there right now including patient satisfaction, 30 day complication rates, 30 day mortality, and all of them together tell a lot about what happens in terms of quality. The article is interesting in that it makes the hypothesis that perhaps if we’re going to measure people in terms of a single measure, physicians may focus on that measure and adapt their care to have a good outcome in terms of that measure rather than really addressing quality globally.  :25

So how can quality be assessed? Califano comments.

Califano: I think you have to take all single measures with a grain of salt and take them in context. But I do think within the next ten years we are entering an era where we will have greater transparency of data, and the more transparency the better.  The more we look at ourselves critically the better we’re going to get.  :14

At Johns Hopkins, I’m Elizabeth Tracey.