Preventable Admissions is a Stupid Metric

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Looks like there is some more trouble in Qualityland:

A new national study looked at preventable hospital readmissions at 43 free-standing children’s hospitals. The analysis showed that some facilities face payment penalties not necessarily because they provide poor quality care, but because their patient populations experience many hardships.

Once again we see how stupid it is to pay doctors and hospitals for issues that are out of their control. As this article states, “excessive readmissions can be explained by a patient’s inability to afford medications after being discharged from the hospital or because they can’t find transportation for a follow-up medical visit.”

I hope the readers of this blog are starting to agree how this quality fad is bogus but it may not matter.  The payment reform train is full steam ahead and these hospitals, in poor areas, are going to get destroyed.  How sad is that?  Instead of paying money to get better nurses and doctors in these hospitals, we now pay that money to an excessive number of administrators who just bean count, go to worthless meetings, eat bagels, drink coffee and dream up worthless things for these nurses and doctors to do.

 

So what is the answer?  Well, the idiots, who created this problem in the first place, have come to the rescue.  Here is what Dr. Helen Burstin, chief scientific officer for the National Quality Forum in Washington, D.C., came up with:

  • One proposal would pay providers based on the progress they make at improving the health of their patients over time.
  • Another would pay them based on the performance of similarly-matched peer organizations.
  • “You might be able to look at hospital groupings by the proportion of poor patients they may have and only compare them to like hospitals that have the same proportion of poor patients.”

I don’t even know that she means with any of these proposals. That’s how stupid they are.  Willie Sutton was asked why he robbed banks and replied, “Because that is where the money is”.   How does this relate here?  Find where the money is going in these hospitals (administrators) and then plow it back into the staff.  No more Press Ganey scores.  No more PQRS.  Just pay for good doctors and good staff and make sure there is enough nurses. These are the people who truly care and will do a good job for patients. Without them, the hospital is just a building.