Want to improve health care? Focus on hospitals

(CNN)As Congress and the Trump administration debate the future of America’s health care system, they should go beyond the issues of access and cost and recognize an equally important priority: that patients come first, so health reform should also focus on quality of care.

Seen statistically in hospitalized patients’ complication and mortality rates, and in the percentages of individuals with chronic diseases who are kept out of the hospital with effective preventative care, these quality “outcomes” are the overlooked elephant in the room for health reform.

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Similarly, doctors and health care professionals can’t effectively set goals and make improvements if they don’t know where they stand. Our experience indicates that doctors and hospital administrators want to provide the best possible care. They mean well. They are mission driven. But they need clear and objective data on their hospital’s performance so they know where to focus their efforts.
Interestingly, to conduct our research we were forced to use 2011 hospital data because the Agency for Healthcare Research and Quality, in 2012 — ostensibly to “enhance confidentiality” — eliminated “state and hospital identifiers” from its National Inpatient Sample (NIS) database. That’s like knowing there’s been a big pileup on the Beltway, but not knowing where.
Outcomes data from every hospital in the United States, analyzed at both the disease level and procedure level, should be compiled and made available for legitimate research and quality improvement purposes.

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We’re not looking to generate tabloid headlines. Hospitals should be given ample time to react to the data and improve. After that, the same type of information should be made publicly available — so that patients, in consultation with their doctors, can select hospitals where they’re most likely to get the best care, rather than those that simply accept their insurance.
Our research should send a strong message to policy makers that good health insurance, no matter how affordable or accessible, is not synonymous with good care.
You don’t go to an Italian restaurant and expect great sushi. Similarly, just because a hospital is good at knee replacements doesn’t mean it’s good at brain surgery. Collecting and analyzing data on outcomes, providing transparency, and driving performance improvements should be core elements of health-care reform. The American people deserve nothing less.

Read more: http://www.cnn.com/2017/01/23/opinions/how-to-improve-health-care-lesser-rosenberg/index.html

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