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This book provides a succinct overview of a variety of aspects of quality that is absent from other texts that cover the technical aspects of operative spine care. Readers are provided with insight and comparisons of different quality reporting systems across different health care systems, while also discussing the different strengths and weaknesses therein. The book summarizes state-of-the-art quality measurement and value assessment in spine care while reviewing quality reporting in the US and internationally. Chapters also outline how quality improvement efforts achieved success in hospital systems. Quality Spine Care: Healthcare Systems, Quality Reporting, and Risk Adjustment provides surgeons and practitioners with insight into the challenging aspects of healthcare delivery and quality assessment related to spine care.
Auteur
John RatliffDepartment of NeurosurgeryStanford UniversityStanford, CAUSA
Todd J. AlbertHospital for Special SurgeryNew York, NYUSA
Joseph ChengDepartment of NeurosurgeryUniversity of Cincinnati College of MedicineCincinnati, OHUSA
John KnightlyNeurosurgery, Atlantic Neurosurgical SpecialistsMorristown, NJUSA
Résumé
Quality reporting is a rapidly growing area. Each year, new regulations in the US from the Council of Medicare and Medicaid Services make quality reporting a larger factor in determining reimbursement practices. Quality metrics are common parts of European clinical practice. Value of care is a focus of all payers, with specific interest directed at assessing the quality of care provided by a given healthcare team. While there are many publications in this space, no text has sought to provide an overview of quality in spine care.
Quality measurement and quality reporting are ever growing aspects of the healthcare environment. Quality assessment is valuable to all healthcare stakeholders: patients, physicians, facilities, and payers. Patients are drawn to facilities that provide high value care; public reporting systems and grading systems for hospitals offer one opinion with regard to high quality care. Most physicians email inboxes are inundated with offers of recognition for being a Top Doc for a nominal fee. Some payers offer incentives to patients who chose to be treated at Centers of Excellence or similar facilities; the definition of Excellence may be unclear.
There is little consensus on how to measure quality, how to incorporate patient and procedure factors and achieve accurate risk adjustment, and how to define value of care. Regardless of these challenges, regulatory efforts in the US, as well as numerous international efforts, make quality assessment and quality reporting an important part of physician behaviour.
Physician and facility reimbursement for procedures are often tied to quality metrics. Spine procedures are costly, elective, and are a focus of many payer-based programs. Hence, spine care is often a focus of quality reporting efforts. This text summarizes the state of the art with regard to quality measurement, reporting, and value assessment in spine care. We will review quality reporting in the US and internationally. Chapters will outline how quality improvement efforts have achieved success in hospital systems. The reader will be provided with insights in how to achieve success incorporating quality metrics into spine care.
Features:
Contenu
Historical Aspects of Quality in Healthcare.- Quality and Standardization of Medical Education.- The History of Quality Assessment in Spine Care.- Choice of Quality Metrics for Assessment of the Spine Patient.- Patient Reported Outcomes.- Registries in Spine Care, United States.- Registries in Spine Care, UK and Europe.- Concepts of Risk Stratification in Measurement and Delivery of Quality.- Risk Adjustment Methodologies.- Healthcare Systems in the United States.- The National Health Service (NHS) in England: Trying to Achieve Value Based Health Care.- Quality Spine Care in Australasia.- Healthcare Systems: India.- Healthcare Systems and Quality Assessment of Spine Care in Japan.- Overview of Healthcare System in China.- Conditions of Care and Episode Groups.- Aligning Healthcare Systems.- Building Quality Metrics into a Practice.- Impact of Quality Assessment on Clinical Practice, Intermountain Healthcare.- Impact of Quality Assessment on Clinical Practice, Kaiser Permanente.- How Quality is Assessed in Insurance Markets.- Centers of Excellence and Payer Defined Quality Assessment.- Reporting Quality Results.- Achieving Success in Quality Reporting.