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Friday, March 9th 2007

Whoops…

Cato @ Liberty points to a NYT’s article that takes an antecedal story about USCF’s time to the cath lab for heart attack patients and draws broad conclusions about health care quality from it.

The most encouraging thing about the U.C.S.F. story is that it points out a way to improve health care that avoids many of the thorniest political debates: regulators should force hospitals to report more information. In 2005-6, about 67 percent of patients across the country had their arteries unblocked within two hours, up from 62 percent a couple of years earlier, according to Medicare, which posts the numbers on the Web.

Don’t get me wrong, I agree that a very important thing is for physicians and hospitals to release outcome information. But consumers need to be prudent in how they judge it. For instance Health Compare uses processes, with no outcome data, to judge hospitals.

Basically it works like this: “Oh, everyone who comes in with an MI gets an ACE Inhibitor” they must be doing well. But of course that sort of ‘performance’ judgment doesn’t have a direct correlation to outcomes.

If you go solely with outcomes the criticism is even louder. Standardizing between parts of the country or even different hospitals in the same area is very difficult. “Well our hospital takes sicker patients of course more of them die.” As well you get people playing to the statistics.

Here is a very good critique of these hospital report cards.

The point is, I support open outcome information – for hospitals and physicians – but I just hope (probably fruitlessly) that people (and reporters) learn how to discriminate and use it appropriately.

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