PPPM460LectureNotesweek#6.pdf PPPM 460
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This 2 page Class Notes was uploaded by Kaitlyn Endo on Friday September 25, 2015. The Class Notes belongs to PPPM 460 at University of Oregon taught by Nicole Ngo in Spring 2015. Since its upload, it has received 32 views.
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Date Created: 09/25/15
PPPM 460 Lecture Notes Week 6 Medicare Star Ratings allow nursing homes to game the systemquot 0 how do we measure quality Is it accurate I Industry is being protected not the patient that s in the home I Medicare nursing home compare site 5 starts but many violations and complaints I People who rely on the website are mislead Cost and quality 0 Variation in costs mystery but becoming more transparent eg data etc I Becoming more transparent as far as cost data I But quality is still lacking and hard to measure 0 Variation in quality myster but ACA working to improve this eg ACOs other Medicare programs I How do we measure it Is it successful I Not mandatory What is quality of care 0 quality of care is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledgequot I health services any service that affects health I individuals and population anyone who is a patient quality fo care across the entire system I increase the likelihood of desired health outcomes not always positive outcomes get closer to the patients desired outcomes I current professional knowledge evidence based research Types of problems with quality 0 Underuse failed to provide a health service when it wouldn ve produced a favorable outcome problem with quality of care 0 Overuse health care service provided under circumstances in which its potential for harm exceeds possible benefits 0 Misue an appropriate service has been selected but a preventable complication occurs and the patient doesn t receive the full potential benefit of the service like dr required to use hand sanitizer before and after meeting with patient but don t always do 0 Little known on quality of health care in the US I No comprehensive data 0 Is managed care or FFS to blame Unclear in the literature I Unclear in the literature Quality of care in the US 0 Schuster et al 1998 Lit review I Results large gaps in care people should receive and the care Quality of care by care and function 0 Overall 55 received recommended care so only half of people receive the care they re supposed to 0 Similar across different types of care and functions 0 Modemechanisms of care delivery medication immunization physical examination lab testing surgery counseling education etc Post acute care quality9 readmissions within 30 days problem with how the treatment was delivered making you go back in Quality and cost 0 Underuse solution more services cost impact more expensive 0 Overuse solution less services cost impact less expensive 0 Misuse solution reducing complications cost impact less expensive Popular argument variation in costs across hospitals re ects variation in the prevalence of illness not medical services What do you notice in this graph below 0 relationship of Medicare reimbursements and hospital care intensity I as hospital care intensifies or grows reimbursements also grows o of medicare enrollees with chronic illnesses and Medicare reimbursements I no real relationship Gawande Why is quality so varied and poor in the US 9 Gawande s The Bell Curvequot How did the care in Cincinnati and Minnesota differ Lack of transparency Data hard to collect Cystic fibrosis foundation the exception the subtleties of medical decision making can be identified and learned The lessons are hidden But if you open the book on physicians results the lessons will be exposed OOOOOO
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