John T Bassett1, Michael L Volk. 1. Department of Gastroenterology, University of Michigan, 1954 Upland Dr, Ann Arbor, MI 48105, USA. JTBassett@aol.com
Abstract
INTRODUCTION: The ultimate purpose of measuring quality of care is to discriminate between healthcare providers in order to motivate improvement. Recently, a set of evidence-based indicators has been proposed for measurement of processes of care for patients with cirrhosis, for example early endoscopy for variceal bleeding. The objective of this study was to determine whether these indicators can be measured in a reliable and automated fashion in routine practice. MATERIALS AND METHODS: We applied the top five indicators, based on agreement of a panel of experts, to hospitalized adults at our institution over a 3-year period. RESULTS: Only two of the indicators could be reliably measured on the basis of the published wording, and these two still required physician chart review. After applying some assumptions, the indicators were met in 46-100% of cases. None of the indicators was linked to a single physician or institution in all cases, and none occurred with sufficient frequency to discriminate quality between providers. CONCLUSION: Measuring quality of care in cirrhosis is a laudable objective, but current indicators are not yet ready for administrative use.
INTRODUCTION: The ultimate purpose of measuring quality of care is to discriminate between healthcare providers in order to motivate improvement. Recently, a set of evidence-based indicators has been proposed for measurement of processes of care for patients with cirrhosis, for example early endoscopy for variceal bleeding. The objective of this study was to determine whether these indicators can be measured in a reliable and automated fashion in routine practice. MATERIALS AND METHODS: We applied the top five indicators, based on agreement of a panel of experts, to hospitalized adults at our institution over a 3-year period. RESULTS: Only two of the indicators could be reliably measured on the basis of the published wording, and these two still required physician chart review. After applying some assumptions, the indicators were met in 46-100% of cases. None of the indicators was linked to a single physician or institution in all cases, and none occurred with sufficient frequency to discriminate quality between providers. CONCLUSION: Measuring quality of care in cirrhosis is a laudable objective, but current indicators are not yet ready for administrative use.
Authors: Fasiha Kanwal; Jennifer Kramer; Steven M Asch; Hashem El-Serag; Brennan M R Spiegel; Steven Edmundowicz; Arun J Sanyal; Jason A Dominitz; Kenneth R McQuaid; Paul Martin; Emmet B Keeffe; Lawrence S Friedman; Samuel B Ho; Francisco Durazo; Bruce R Bacon Journal: Clin Gastroenterol Hepatol Date: 2010-04-10 Impact factor: 11.382
Authors: Darius Sorbi; Christopher J Gostout; David Peura; David Johnson; Frank Lanza; P Gregory Foutch; Cathy D Schleck; Alan R Zinsmeister Journal: Am J Gastroenterol Date: 2003-11 Impact factor: 10.864