Another recent study has exposed the limitations of the current quality indicators used by Medicare and many insurance companies. This time it’s for in-hospital patient deaths.
Researchers looked at the mortality rate for patients admitted for pneumonia to 303 California hospitals. Hospitals were lumped into groups of performance using the standard quality measures. Then the figured out which patients had Do-Not-Resuscitate (DNR) orders written in their medical record physician orders section. Without accounting for DNR status, hospitals with high mortality rates had higher DNR rates. After accounting and statistically adjusting for DNR order status, the hospitals with higher DNR rates actually had lower mortality than hospitals with low DNR order rates.
Only 52% of hospitals in the low-performing group stayed in that group when DNR order rates were considered.
Taking care of patients continues to be more complex than the computers and big data can keep up with.