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Las consecuencias no deseadas de informar públicamente información de calidad

Rachel M Werner¹, David A Asch

¹Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center;

|March 10, 2005

Resumen

Informar públicamente los datos de calidad de la atención médica tiene como objetivo mejorar la atención, pero su efectividad no está probada. Las posibles consecuencias negativas, como el sesgo de selección de pacientes, pueden socavar los esfuerzos de mejora de la calidad.

Área de la Ciencia:

Servicios de salud Investigación Servicios de salud Investigación
Mejora de la Calidad Ciencia Mejora de la Calidad

Sus antecedentes:

El informe público de los datos de calidad de la atención médica está destinado a impulsar mejoras en el desempeño del médico, el hospital y el plan de salud.
Los presuntos mecanismos de mejora incluyen la selección informada de pacientes y la competencia de médicos basada en métricas de calidad.

Objetivo del estudio:

Evaluar el valor demostrado de informar públicamente la información sobre la calidad de la atención médica.
Identificar las posibles consecuencias negativas no deseadas de los informes públicos de calidad.

Principales métodos:

Este estudio es una revisión y análisis críticos de la literatura y la evidencia existentes con respecto a los informes de calidad pública.
La metodología implica examinar los fundamentos teóricos y los resultados observados de las iniciativas de informes de calidad.

Principales resultados:

El valor de los informes públicos de calidad en la mejora de la calidad de la atención médica sigue sin demostrarse en gran medida.
Las posibles consecuencias negativas incluyen que los médicos eviten a los pacientes más enfermos y la adherencia inapropiada a las "tasas objetivo" para las intervenciones.
Las preferencias del paciente y el juicio clínico pueden ser descontados.

Conclusiones:

Si bien los informes públicos fomentan la transparencia, no se ha establecido su capacidad para mejorar de manera demostrable los resultados de salud.
Los informes públicos pueden disminuir inadvertidamente la calidad de la atención médica.
Es necesaria una reevaluación del papel de los informes públicos de calidad en las iniciativas de mejora de la calidad.

Palabras clave:

Atención médica y salud pública.

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