3 Quality Measures to Consider When Making Healthcare Decisions

3 Quality Measures to Consider When Making Healthcare Decisions

When the need for surgery arises, most patients turn to their friends, family members, or primary care provider for a recommendation on which surgeon to choose. While it certainly can be reassuring to see someone who is trusted by your community, there are several quality measures that can’t be verified by a word of mouth referral.

A lack of proper research into the quality, experience, or outcomes of a surgeon (or the hospital where he/she operates) opens you up to a multitude of risks — complications, readmission, mortality, as well as just an overall negative experience. Of course, no surgery is without risks. But many of them can be avoided or, at the very least, mitigated by taking steps to ensure that you receive quality healthcare.

Since variance in quality between different surgeons and hospitals can be so extreme, it’s important to understand which quality metrics to research and why they’re so important. Understanding these will protect your health and your wallet — the complications caused by poor quality healthcare can jeopardize your recovery and will certainly end up costing you more money.

Below, you’ll find 3 quality measures you should consider when making healthcare decisions.

Healthcare Quality Measure #1: Surgeon and Hospital Procedure Volume

Generally speaking, the more a surgeon performs a certain type of procedure, the better they get at it. As they get better, the quality and outcomes improve, too. This isn’t just theory; there have been numerous studies that have confirmed this to be true. Let’s take a look at one example.

For a 2004 study on the “association between hospital and surgeon procedure volume and the outcomes of total knee replacement,” researchers analyzed claims data for Medicare patients who had received a knee replacement within the span of 8 months. Here are the results:

Compared with patients who had a primary total knee replacement done by surgeons with an annual volume of 12 or fewer, those operated on by surgeons who performed 50 or more procedures each year had a lower risk of complications, including:

  • Pneumonia
  • Death
  • Pulmonary embolism
  • Acute myocardial infarction
  • Infection

Interestingly, the study also found that, compared to hospitals where 25 or fewer knee replacements were performed each year, hospitals with an annual volume of 200 or more of the same procedure had proportionally similar results. Other studies have explored the same concept with different surgical procedures like coronary bypass and lumbar spinal fusion. The actual statistics may vary but the overall consensus is the same: higher surgical procedure volume is a good indicator of quality outcomes.

In fact, starting in early 2016, the U.S. News Doctor Finder started providing information on the number of medical procedures a doctor performs annually. This is a great tool to use when you’re choosing a surgeon.

Healthcare Quality Measure #2: Complication Rates

When you’re choosing where to have surgery or which surgeon to use, one key metric to research is complication rates. These can be summed up in 3 categories, all typically measured in 30 and 90-day increments: surgical complications such as infections, readmissions and mortality (death) rates.

There are many reasons for complications that come up during or after surgery, ranging from your personal health issues (not always related to what you’re having surgery for) to medical malpractice or neglect. Within that range exists a slew of other possible reasons, many of which can be prevented.

Measures have been taken to help incentivize hospitals and surgeons to work toward lowering readmission rates. This is done by charging a monetary penalty for readmissions that exceed an expected percentage, based on the type of procedure.

While it is important to look at hospital readmission and mortality rates, the American College of Surgeons has said that surgeons can reasonably be held responsible for complications, even those that didn’t occur because of them directly. ProPublica launched a tool, the Surgeon Scorecard, that can help patients identify different metrics about their surgeon, including readmission and mortality rates.

Healthcare Quality Measure #3: Patient Satisfaction

Patient satisfaction, though not as easy to measure as procedure volume, readmission rates, or mortality rates, is important. In fact, your surgeon and the hospital they operate out of probably use patient satisfaction as a metric of their own success at delivering quality health care. It stands to reason, then, that you can (and should) do the same.

You can get a strong sense of patient satisfaction by asking your surgeon to provide references from patients they’ve performed the same surgery on. You can also ask that the hospital you’re considering provide similar references. If you can get feedback from patients who were operated on by the same surgeon, at the same hospital, for the same procedure, that would be even better.

Carrum Health only works with highly experienced surgeons that have high procedure volumes and outstanding outcomes, results, and patient satisfaction. We analyze data and do all the homework so patients like you can have peace of mind knowing they are going to an expert in their particular field.

Register now to start using your Carrum Health benefit!