Do performance measures matter?


Category : Medical Rants

Heart Failure Performance Measures Trivial For Survival

Performance measures adopted by the government to gauge hospital quality of care for heart failure have little impact on survival during the critical early post-discharge period, researchers here reported.

None of the heart failure performance measures used by Medicare and Medicaid, plus the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), significantly predicted 60- or 90-day mortality, found Gregg C. Fonarow, M.D., of the UCLA Medical Center, and colleagues in an analysis of a large registry.

When the combined outcome of post-discharge mortality or re-hospitalization was assessed, only ACE inhibitor or angiotensin receptor blocker use at discharge was a strong influence, they reported in the Jan. 3 issue of the Journal of the American Medical Association.

“These findings may have significant clinical and public health implications,” they wrote, “and suggest that additional measures may be required to more effectively quantify the quality of care provided to heart failure patients in the hospital setting.”

Perhaps the concept of performance measures has flaws. Medical care has greater complexity than simple rules would suggest. Performance measures must oversimplify the processes of care. This topic reminds me of the blind men describing an elephant. Blind Men and the Elephant

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Comments (1)

I am also reminded about the old saying: a camel is a horse designed by a committee. (apologies to all camel lovers out there!”

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