Who is watching the watchmen: Is quality reporting ever harmful?

SAGE Open Medicine
R Scott Braithwaite, Arthur Caplan

Abstract

Quality reporting is increasingly used as a tool to encourage health systems, hospitals, and their practitioners to deliver the greatest health benefit. However, quality reporting systems may have unintended negative consequences, such as inadvertently encouraging "cherry-picking" by inadequately adjusting for patients who are challenging to take care of, or underpowering to reliably detect meaningful differences in care. There have been no reports seeking to identify a minimum level of accuracy that ought to be viewed as a prerequisite for quality reporting. Using a decision analytic model, we seek to delineate minimal standards for quality measures to meet, using the simplest assumptions to illustrate what those standards may be. We find that even under assumptions regarding optimal performance of the quality reporting system (sensitivity and specificity of 1), we can identify a minimal level of accuracy required for the quality reporting system to "do no harm": the increase in health-related quality of life from a higher rather than lower quality practitioner must be greater than the number of practitioners per patient divided by the proportion of patients willing to switch from a lower to a higher quality provider. Quality ...Continue Reading

References

Jan 1, 1978·Health Education Monographs·K A WallstonR DeVellis
Jun 8, 2000·Medical Care·T O Tengs, A Wallace
Jan 16, 2002·The Annals of Thoracic Surgery·D M ShahianP I Dreyer
Mar 17, 2004·American Journal of Physical Medicine & Rehabilitation·Lisa I Iezzoni
Mar 31, 2004·Lancet·Peter J PronovostHaya Rubin
Oct 16, 2004·Journal of Critical Care·Peter J Pronovost, Christine G Holzmueller
Aug 23, 2005·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Stephen J Walters, John E Brazier
Nov 10, 2007·BMJ : British Medical Journal·Eve A Kerr, Barbara Fleming
Oct 22, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Jack V TuUNKNOWN Canadian Cardiovascular Outcomes Research Team / Canadian Cardiovascular Society Acute Myocardial Infarction Quality Indicat
Nov 20, 2008·BMC Medical Research Methodology·Byron J GajewskiNancy Dunton
Aug 12, 2009·The Spine Journal : Official Journal of the North American Spine Society·Daniel K ResnickMichael P Steinmetz
May 19, 2010·Contemporary Clinical Trials·Rachel StanleyUNKNOWN Pediatric Emergency Care Applied Research Network (PECARN)
Jul 14, 2010·Journal of General Internal Medicine·Jon B ChristiansonDennis P Scanlon

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

© 2022 Meta ULC. All rights reserved