|Selected research from leading health care experts whose findings have a direct bearing on public policies effecting medical progress. Research is chosen based on its quality and relevance by the Medical Progress Today editorial staff.||
Although, as we noted above, there are pervasive problems in American health care that affect the allocation of resources and the quality of care delivered to patients, not all of the news is grim. There are some signs, in fact, that the very effort to track quality outcomes encourages improvement:
"In July 2002, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) implemented standardized performance measures that were designed to track the performance of accredited hospitals and encourage improvement in the quality of health care," write Scott C. Williams, PsyD, from the JCAHO, and colleagues. "Both qualitative and quantitative studies have demonstrated benefits associated with providing hospitals regular feedback on their performance on quality measures. Comparative feedback has been particularly useful at an organizational level as a guide for improvement-oriented activities."
For a two-year period, the investigators reviewed the performance of more than 3,000 accredited hospitals on 18 standardized indicators of the quality of care for acute myocardial infarction, heart failure, and pneumonia. One measure evaluated the clinical outcome of in-hospital death after acute myocardial infarction, and the other 17 measures evaluated processes of care. All hospitals enrolled in the study received comparative reports for quarterly feedback.
The performance of U.S. hospitals improved…in 15 (83%) of 18 measures and did not deteriorate significantly on any measure. During the eight quarters studied, the magnitude of improvement ranged from 3% to 33%. For 16 (94%) of the 17 process-of-care measures, hospitals with a low baseline level of performance had greater improvements than did hospitals with a high baseline level of performance.
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