Cost and Quality Analysis

Topics: Health care, Healthcare quality, Medicine Pages: 5 (1595 words) Published: November 2, 2013


Cost and Quality Analysis
Karen Ninassi
Ethics Policy and Finance in the Health Care System
September 18, 2013

Cost and Quality Analysis
Effectiveness, safety, timeliness, patient-centered, equitable, and efficient are all elements of quality (McGlynn, 2005). The Institute of Medicine noticed that only half the time patients are getting effective care, disparities in direction remain extensive, medications errors are common, and enhancement of quality and efficiency could eliminate greater than 30% of healthcare costs (McClellan, 2013). It is estimated that in 2007 the national cost of healthcare was $2.2 trillion, or $7,500 per United States (US) resident. Health care expenditures explain 16.2 percent of the Gross Domestic Product and national health spending accounts for approximately 33% for hospitals, 20% for physician services, and 10% for pharmaceuticals. Costs are escalating rapidly in the US than any other country globally (“Guiding Principles,” 2008). Questions arise as to the relationship between quality and cost. Will increased cost result in superior care, or will superior outcomes assist in the containment of cost? Indication of the direction of quality and healthcare costs are unpredictable. Studies have shown that the link between the two is small to moderate, irrespective of whether the path is positive or negative (Hussey, Wertheimer, & Mehrotra, 2013). Roles

The Agency for Healthcare Research and Quality (AHRQ) is a branch of the US Department of Health and Human Services. Their role is to reinforce research intended to develop the quality of healthcare, decrease its cost, improve patient safety, reduce medical errors, an expand access to vital services (“Related Public/Private,” 2008). The Joint Commission’s role is to constantly advance the safety and quality of care delivered to the public through the establishment of health care accreditation and associated services that back performance improvement in healthcare systems (“Related Public/Private,” 2008). Activities

AHRQ has many major activities that address quality and cost in healthcare. One activity is the use of risk management theory by nurses. Effective risk management necessitates nurses to identify risks before they happen to the patient. Jointly with a medication database, the medication regimen complexity index tool is used for measuring numerous characteristics of drug regimen complexity to decrease adverse reactions and higher costs, which is yet another activity used by the AHRQ (“Automated Tool,” 2013). The Joint Commission, on the other hand, has the Core Measure Solution Exchange®. This is a web-based forum devoted to communicating solutions related to improving core measure performance rates (“Hospital Resources,” 2013). The National Patient Safety Goals is a sequence of exact activities to stop medication errors , for example miscommunication between healthcare providers, unsafe use of infusion pumps, and medication mistakes (“Joint Commission,” 2013). Both of these agencies are working together on some topics. The National Quality Measures Clearinghouse endorses extensive access to quality measures by the healthcare community (“Specifications Manuel,” 2013). It is sponsored by the AHRQ and includes Joint Commission measures. Current and Projected Initiatives

AHRQ funded a national attempt to stop central line-associated bloodstream infections in US hospitals by executing a Comprehensive Unit-based Safety Program (“Eliminating CLABSI,” 2013). Another initiative that is hallmark is their support of a culture of patient safety and quality enhancements in healthcare organizations in the Nation, entitled, Hospital Survey on Patient Safety Culture. They subsidized the progress of patient safety culture assessment tools and sponsored the development of a comparative database on the survey (“Hospital Survey,” 2013). AHRQ initiated the Healthcare Cost and Utilization Project. This empowers research on a...

References: Automated tool to determine medication regimen complexity may help identify patients at high risk of adverse events. (2013). Retrieved, from AHRQ at http://www.ahrq.gov/news/newsletters/research-activities/13sep/0913RA7.html
Core measure sets
Eliminating CLABSI, a National patient safety imperative: Final report. (2013). Retrieved from AHRQ at http://www.ahrq.gov/professionals/quality-patient-safety/cusp/clabsi-final/index.html
Facts about the cooperative accreditation initiative
Guiding principles for the development of the hospital of the future. (2008). Retrieved, from The Joint Commission at http://www.jointcommission.org/assets/1/18/Hosptal_Future.pdf
Healthcare cost and utilization project (HCUP)
Hospital resources and tools. (2013). Retrieved, from The Joint Commission at http://www.jointcommission.org/accreditation/hospital_resources_and_tools.aspx
Hospital survey on patient safety culture
Joint Commission FAQ page. (2013). Retrieved, from The Joint Commission at http://www.jointcommission.org/about/JointCommissionFaqs.aspx
McClellan, M.B
McGlynn, E. A. (2005). U.S. health care: Facts about cost, access, and quality. Retrieved from Rand Health at http://www.rand.org/content/dam/rand/pubs/corporate_pubs/2005/RAND_CP484.1.pdf
Needlemen, J
Specifications manual for Joint Commission national quality measures (v20135). (2013). Retrieved, from The Joint Commission at http://manual.jointcommission.org/releases/TJC2013B/IntroductionTJC.html
Related public/private initiatives
Wakefield, M. D. (2008). The quality chasm series: Implications for nursing. In R. G. Hughes (Ed.) Patient safety and quality: An evidence-based handbook for nurses, pp. 1-47-1-66. Retrieved, from NCBI at http://www.ncbi.nlm.nih.gov/books/NBK2677/
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