Measuring Quality in Health Care and Its Implications for Pay-For-Performance Initiatives

Hand Clinics

Volumn 25, Issue 1, 2009, Pages 71-81

  Chung, Kevin C ^a   Shauver, Melissa J ^a  

^a UNIVERSITY OF MICHIGAN HEALTH SYSTEM   (United States)

Author keywords

Hand surgery; Health care; Outcomes; Pay for performance; Quality

Indexed keywords

CLINICAL PRACTICE; CONSUMER; DATA ANALYSIS; FINANCIAL MANAGEMENT; FUNDING; GOVERNMENT; HAND SURGERY; HEALTH CARE; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH PROGRAM; PHYSICIAN; QUALITY CONTROL; REVIEW; SURGEON; TOTAL QUALITY MANAGEMENT; WESTERN HEMISPHERE;

DELIVERY OF HEALTH CARE; HAND INJURIES; HUMANS; ORTHOPEDICS; OUTCOME ASSESSMENT (HEALTH CARE); PHYSICIAN INCENTIVE PLANS; QUALITY OF HEALTH CARE; UNITED STATES;

EID: 60349083845     PISSN: 07490712     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.hcl.2008.09.001     Document Type: Review

References (61)

1. Kaiser health tracking poll: election 2008 (2007), The Henry J. Kaiser Family Foundation, Menlo Park (CA)
2. Blendon R.J., Altman D.E., Benson J.M., et al. Health care in the 2004 presidential election. N Engl J Med 351 13 (2004) 1314-1322
3. Health care and the Democratic presidential campaign: CBS News; September 17, 2007.
4. Kaiser Family Foundation poll. Storrs, CT: Roper Center for Public Opinion Research; 2007.
5. National health expenditure accounts: 2006 highlights. Available at:. http://www.cms.hhs.gov/NationalHealthExpendData/downloads/highlights.pdf Accessed March 3, 2008
6. The World Health Report 2000. Health systems: improving performance. Available at:. http://www.who.int/whr/2000/en/whr00_en.pdf Accessed March 3, 2008
7. Catlin A., Cowan C., Hartman M., et al. National health spending in 2006: a year of change for prescription drugs. Health Aff 27 1 (2008) 14-29
8. Reinhardt U.E. The Swiss health system: regulated competition without managed care. JAMA 292 10 (2004) 1227-1231
9. Bozic K.J., Smith A.R., and Mauerhan D.R. Pay-for-performance in orthopedics: implications for clinical practice. J Arthroplasty 22 6 Suppl 2 (2007) 8-12
10. Pierce R.G., Bozic K.J., and Bradford D.S. Pay for performance in orthopaedic surgery. Clin Orthop Relat Res 457 (2007) 87-95
11. Chung KC, Rohrich RJ. Measuring surgical quality: is it attainable? Plast Reconstr Surg, in press.
12. Hsiao W.C., Braun P., Dunn D., et al. Results and policy implications of the resource-based relative-value study. N Engl J Med 319 13 (1988) 881-888
13. Sherrid P. Mismanaged care?. US News World Rep 123 (1997) 57-62
14. Ghori A.K., and Chung K.C. Market concentration in the healthcare insurance industry has adverse repercussions on patients and physicians. Plast Reconstr Surg 121 6 (2008) 435e-440e
15. Institute of Medicine. To err is human: building a safer health system. Available at:. http://www.iom.edu/CMS/AboutIOM.aspx Accessed April 24, 2008
16. To err is human: building a safer health system. Washington, DC 2000.
17. Crossing the quality chasm: a new health system for the 21st century (2001), Institute of Medicine, Washington, DC
18. Blumenthal D. Part 1: quality of care-what is it?. N Engl J Med 335 12 (1996) 891-894
19. Brook R.H., McGlynn E.A., and Cleary P.D. Quality of health care. Part 2: measuring quality of care. N Engl J Med 335 13 (1996) 966-970
20. Donabedian A. The quality of care: how can it be assessed?. JAMA 260 12 (1988) 1743-1748
21. Donabedian A. Twenty years of research on the quality of medical care: 1964-1984. Eval Health Prof 8 3 (1985) 243-265
22. Glickman S.W., Ou F.S., DeLong E.R., et al. Pay for performance, quality of care, and outcomes in acute myocardial infarction. JAMA 297 21 (2007) 2373-2380
23. Lambert-Huber D.A., Ellerbeck E.F., Wallace R.G., et al. Quality of care indicators for patients with acute myocardial infarction: pilot validation of the indicators. Clin Perform Qual Health Care 2 (1994) 219-222
24. Birkmeyer J.D., Siewers A.E., Finlayson E.V.A., et al. Hospital volume and surgical mortality in the United States. N Engl J Med 346 (2002) 1128-1137
25. Birkmeyer J.D., Stukel T.A., Siewers A.E., et al. Surgeon volume and operative mortality in the United States. N Engl J Med 349 (2003) 2117-2127
26. Daley J. Invited commentary: quality of care and the volume-outcome relationship. What's next for surgery?. Surgery 131 1 (2002) 16-18
27. Sheikh K. Reliability of provider volume and outcome associations for healthcare policy. Med Care 41 10 (2003) 1111-1117
28. Birkmeyer J.D., Dimick J.B., and Birkmeyer N.J. Measuring the quality of surgical care: structure, process, or outcomes?. J Am Coll Surg 198 4 (2004) 626-632
29. Darr K. The Centers for Medicare and Medicaid Services proposal to pay for performance. Hosp Top 81 2 (2003) 30-32 Spring
30. Bhattacharyya T., and Hooper D.C. Antibiotic dosing before primary hip and knee replacement as a pay-for-performance measure. J Bone Joint Surg Am 89 2 (2007) 287-291
31. Birkmeyer N.J., and Birkmeyer J.D. Strategies for improving surgical quality: should payers reward excellence or effort?. N Engl J Med 354 8 (2006) 864-870
32. Broder M.S., Payne-Simon L., and Brook R.H. Measures of surgical quality: what will patients know by 2005?. J Eval Clin Pract 11 3 (2005) 209-217
33. Kroon H.M., Breslau P.J., and Lardenoye J.W. Can the incidence of unplanned reoperations be used as an indicator of quality of care in surgery?. Am J Med Qual 22 3 (2007) 198-202
34. Glance L.G., Dick A., Osler T.M., et al. Impact of changing the statistical methodology on hospital and surgeon ranking: the case of the New York State cardiac surgery report card. Med Care 44 4 (2006) 311-319
35. Khuri S.F., Daley J., and Henderson W.G. The comparative assessment and improvement of quality of surgical care in the Department of Veterans Affairs. Arch Surg 137 1 (2002) 20-27
36. Khuri S.F. Safety, quality, and the National Surgical Quality Improvement Program. Am Surg 72 11 (2006) 994-998
37. Bhattacharyya T., Iorio R., and Healy W.L. Rate of and risk factors for acute inpatient mortality after orthopaedic surgery. J Bone Joint Surg Am 84-A 4 (2002) 562-572
38. Chung K.C., Burns P.B., and Davis Sears E. Outcomes research in hand surgery: where have we been and where should we go?. J Hand Surg 31A 8 (2006) 1373-1379
39. Chung K.C., Watt A.J., Kotsis S.V., et al. Treatment of unstable distal radial fractures with the volar locking plating system. J Bone Joint Surg 88A 12 (2006) 2687-2694
40. Chung K.C., Kotsis S.V., and Kim H.M. A prospective outcomes study of Swanson metacarpophalangeal joint arthroplasty for the rheumatoid hand. J Hand Surg 29A 4 (2004) 646-653
41. Beaton D.E., Katz J.N., Fossel A.H., et al. Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different regions of the upper extremity. J Hand Ther 14 2 (2001) 128-146
42. Khuri S.F. The NSQIP: a new frontier in surgery. Surgery 138 5 (2005) 837-843
43. National Committee for Quality Assurance. What is HEDIS? Available at: http://www.ncqa.org/tabid/187/Default.aspx. Accessed March 18, 2008.
44. Pawlson L.G., Scholle S.H., and Powers A. Comparison of administrative-only versus administrative plus chart review data for reporting HEDIS hybrid measures. Am J Manag Care 13 10 (2007) 553-558
45. Steinbrook R. Public report cards: cardiac surgery and beyond. N Engl J Med 355 18 (2006) 1847-1849
46. Hospitals: how safe?. Available at:. http://www.consumerreports.org/cro/health-fitness/health-care/hospitals- how-safe-103/hospital-report-cards/ Accessed April 8, 2008
47. Krumholz H.M., Rathore S.S., Chen J., et al. Evaluation of a consumer-oriented internet health care report card: the risk of quality ratings based on mortality data. JAMA 287 10 (2002) 1277-1287
48. Australian Medical Association. AMA public hospital report card 2007.
49. Shojania K.G., and Forster A.J. Hospital mortality: when failure is not a good measure of success. Can Med Assoc J 179 2 (2008) 153-157
50. Zamvar V. Reporting systems for cardiac surgery. BMJ 329 7463 (2004) 413-414
51. Schneider E.C., and Epstein A.M. Use of public performance reports: a survey of patients undergoing cardiac surgery. JAMA 279 20 (1998) 1638-1642
52. Schneider E.C., and Epstein A.M. Influence of cardiac-surgery performance reports on referral practices and access to care: a survey of cardiovascular specialists. N Engl J Med 335 4 (1996) 251-256
53. Gupta S. Rating your doctor. Time New York 171 (2008) 62
54. Galvin R.S., Delbanco S., Milstein A., et al. Has the leapfrog group had an impact on the health care market?. Health Aff (Millwood) 24 1 (2005) 228-233
55. Rosenthal M.B., Frank R.G., Li Z., et al. Early experience with pay-for-performance: from concept to practice. JAMA 294 14 (2005) 1788-1793
56. Werner R.M., and Bradlow E.T. Relationship between Medicare's hospital compare performance measures and mortality rates. JAMA 296 22 (2006) 2694-2702
57. Russell T.R. The future of surgical reimbursement: quality care, pay for performance, and outcome measures. Am J Surg 191 3 (2006) 301-304
58. The Leapfrog Groups for Patient Safety. Available at:. http://www.leapfroggroup.org/ Accessed April 25, 2008
59. Report brief. Rewarding provider performance: aligning incentives in Medicare (2006), Institute of Medicine, Washington (DC)
60. Rosenthal M.B., and Dudley R.A. Pay-for-performance: will the latest payment trend improve care?. JAMA 297 7 (2007) 740-744
61. Hunter J.G. Appropriate prophylactic antibiotic use in plastic surgery: the time has come. Plast Reconstr Surg 120 6 (2007) 1732-1734