Views
CAPC Palliative Care Discussion Forum
Data Collection and Measurement
Quality and Mortality questionsAuthor: rsawicki
Date: Mar 2, 2012 11:55 am
Replies:
order by
[Date]
[Author]
[Subject]
| Re:Quality and Mortality questions (by aherman on 03/04/2012)
This is a little bit tricky. Our hospital uses Premier. I think what you're trying to get at is observed vs. expected. the only way I am aware of pulling the mortalities that palliaitve care is involved with is if you actually discharge patients from Acute inpatient status and readmit as hospice status. this should be transparent as far as patient care, but you must be working closely with a hospice agency who will enroll them. this essentially would remove an observed death lowering your mortality index (O/E). my understanding is that hospice deaths are not included in the mortality statistics produced. V66.7 itself does not allow any reclasification of mortality... unless your local administration is willing to consider it. The problem is that v66.7 really doesn't mean anything...
|
|
| Re:Quality and Mortality questions (by jbcassel on 03/05/2012)
It all hinges on what you'd consider to be a 'good way' to to do this. And the payers and others are actually the ones with the control and power regarding the measures they endorse. Each of the benchmarking (UHC, Premier etc.) groups and each of the public comparison groups (CMS Hospital Compare, US News & World Report, HealthGrades, etc.) would tell you that their approach to exclusions and risk-adjustments are 'good', and they all differ. So, currently, there are a variety of ways you can compare your hospital mortality scores to other systems, and each differs. CAPC has examined this issue and summarized it at http://www.capc.org/tools-for-palliative-care-programs/admin-tools/other/mortality-tech-assist-20091214.pdf . See also http://www.jpsmjournal.com/article/S0885-3924(10)00654-8/abstract and the comments & our response following that article. Once you've looked through those let me know what you think. - Brian Cassel, VCU Massey Cancer Center, Palliative Care Leadership Center.
|
|
| Re:Quality and Mortality questions (by rsawicki on 03/05/2012)
Thank you for the above replies. I will share this information with our Decision Support team and let you know if they have any thoughts. My response is that I am not surprised this isn't well defined, as we are trying to define something like "unexpected" death, or "appropriate" death, and develop a measure around those broad terms that doesn't lend itself easily to being manipulated (manage to the measure). Yet, we need a way to demonstrate the value of appropriate services, and to do so across the continuum of care; how do we measure in the home setting, or SNF setting? Where is the location of death most appropriate, and when? These are not easily answered, and not readily measured as a result. I don't have the solution, but welcome ongoing discussion. thanks.
|
IMPORTANT: In order to post a new message or reply to an existing post in the discussion you must login. If you are not a registered member you may join here.
The statements posted in the forum section of capc.org are opinions expressed by website visitors and do not necessarily represent the viewpoints or positions of the Center to Advance Palliative Care(CAPC). CAPC is not responsible for the factual or legal accuracy of any of the statements posted.
General questions about using the CAPCconnect™ palliative care discussion forum?
Email: Jennifer.Raiten@mssm.edu
Lost login username/password questions? Email: Margaret.Schutz@mssm.edu
