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Measuring hospital outcomes from a buyer's perspective
M V Pauly1, D J Brailer, G Kroch
1Health Care Systems Department, University of Pennsylvania, Philadelphia 19104-6218, USA.
Summary
This study developed a flexible method for corporate buyers to rate hospital quality using existing data. This helps assess healthcare quality and costs as insurance plans increasingly prefer specific hospitals.
Area of Science:
- Health Services Research
- Quality Improvement Science
Background:
- The shift in health insurance towards preferred provider networks necessitates objective hospital quality assessment.
- Corporate buyers require reliable methods to evaluate healthcare outcomes and costs across local hospital markets.
Purpose of the Study:
- To develop and demonstrate a flexible, generalizable, and valid method for assessing hospital quality using secondary data.
- To provide corporate buyers with tools to rate the outcomes quality of hospitals within their local market area.
Main Methods:
- Utilized large hospital discharge databases, exemplified by the Pennsylvania Health Care Cost Containment Council (PHC4) data.
- Developed a set of rating methods designed to address data uncertainty in diagnoses and treatments.
- Demonstrated a process for the general development of quality measures applicable to healthcare outcomes.
Main Results:
- Successfully developed and demonstrated a novel set of hospital quality rating methods.
- The methods effectively handle uncertainty in secondary hospital discharge data.
- Provided a critique of existing quality measures, highlighting areas for improvement.
Conclusions:
- The developed methods offer a valid and practical approach for corporate buyers to assess hospital quality.
- This approach can be generalized for the development of future healthcare quality measures.
- The project highlights the importance of robust data analysis for informed healthcare purchasing decisions.