Monday, October 15, 2012
The Policy Behind Measuring Health Outcomes
We are discussing in our Foundations class right now the concepts of value, both in defining what value means in health care, and also, how to measure it. I came across this Health Affairs article through the California Health Care Foundation website. It discusses a research institute which was funded by the ACA and will attempt to look at outcomes which are particularly relevant to patients. The institute only has funding until 2019. This gets at yet another issue in measuring our system's progress: many of the evaluators are funded through the government and only for a very short time. How can an institute that is essentially brand new put together a research agenda and execute it in such a short time period? Even if this program were to advocate and receive more funding in 2019, the way that evaluation of outcomes is treated as an afterthought in our healthcare system will only ensure that we never get the data adequate to learn from our mistakes.
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Thanks for posting this, Justin!
Measuring outcomes is a topic that has come up a lot in the Quality Improvement class that Michele and I are taking (and that I highly recommend to anyone who finds this topic interesting!!) I'd love to hear Michele's take on this, but my impression is that the two greatest barriers to measuring outcomes are defining the scope of the problem and resistance on the part of many physicians based on the impression that the result of outcomes research is that payors and/or managers of provider systems are going to use the results to tell doctors what they can and cannot do.
I guess it's not surprising, then, that there is resistance to a poorly-funded governmental agency that is tasked with spear-heading CER, given the general lack of confidence in government bureaucracy. I personally struggle with what the right answer is - is PCORI the best organization to run these trials? If not, then who?
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