10.2 Health Outcomes and Quality Care Flashcards
Health Outcomes
- End results that follow some kind of healthcare provision, treatment, or intervention and may describe patient’s condition or health status.
How to measure a Health Outcome
- Mortality, Life expectancy, (Public health metric) and used to demonstrate contribution of disease to population mortality
- New trends in healthcare outcomes is measured in qualitative metrics such as self-perceived health status and psychological well being
How do we measure health of individuals
- Lab Values
- Physical Exams
- Presence of Disease
- Screenings
How do we Measure Health of a Population
- Mortality Rates
- Morbidity Rates
- Presence of disease (%)
- Life expectancy
- Quality of Life
Measure Health Depending the Stage of Lifespan
Childhood - Growth and development, socialization, school skills, learning skills
Adulthood - Absence of disease, healthy relationships, societal performance
OUTCOME METRICS FOR POPULATION HEALTH
Life Expectancy at Birth
- The average number of years a newborn is expected to live if mortality patterns at the time of birth remain constant in the future
Life Expectancy at a Later Point
- Prediction of how life expectancy might change over time
Measurement of Premature Death
Years of potential life lost (how many years have been taken off one’s life)
- Premature mortality rate is deaths of young people that could have been prevented
Crude Mortality
- Total number of deaths to residents in a specific geographical area divided by total population of the area
Age Adjusted Mortality
- Death rates that control the effect of differences in population of age distributions
Characteristic Adjusted Mortality
- Death rates based on a defined characteristic
OUTCOME METRICS
- Do not tell us overall health of population or account for cultural differences
US POPULATION METRIC SOURCSE
- National Vital System (NVSS)
National Surveys - NHIS (National History Information Survey)
- BRFSS (Behavioral Risk Factor Survey System)
- NHANES (National Health and Nutritional Survey)
- NSDUH (National Survey on Drug Use and Health)
State/Local Surveys - Usually based on NHIS and NHANES
Sources of Population Health Outcome Data
- ANA National Database and Nursing Quality Indicators
- Virginia Department of Health
- HP2020
- AHRQ (Agency for Healthcare Research and Quality)
- National Healthcare Quality Report
Measure of Health, Function, Subjective Well-being
- Health Function and Subjective Well Being (Experiential State)
SURVEYS - National Interview Survey (NHIS)
- Behavior Risk Factors Surveillance Survey (BRFSS)
- Surveys include health-related quality-of-life measures that address health domains of mobility, emotional state, cognition, social function, freedom from pain
- They also include incidence and prevalence data on diseases
- Rates of accessing care and health utilization are frequently used as surrogates for disability, loss of function, or lack of well-being
- These surveys are opinion based and hard to gauge and generalize
Why Measure Health Outcomes
- To know if interventions are working
- To examine how well we are helping a population
- Examine quality of methods
Who What When Approach
Who - Measures target of intervention
(Individual, Aggregate, Community, Population)
What - Measures type of outcome
(Care-Related, Performance-Related)
When - Measures the time frame of outcome
(Short-Term, Intermediate-Term, Long-Term)
Structure, Process, Outcome Approach
- Structure - Measures resources to provide quality care
(Infrastructure, demographics, technology, education, number/type of health facilities, health service utilization) - Process - Measures how well community works together to build capacity to solve problems (resources, power)
- Outcomes - Measures phenomena associated with vital statistics
Structure
- Infrastructure
- Demographics
- Technology
- Education
- Facilities
(Number and type of health services/staff, and health service utilization)
Process
- Diagnosis
- Treatment
- Appropriateness
- Process of Care
- Resources Requirements
Outcomes
- Mortality
- Morbidity
- Cost
- Factors Creating Cost
- Quality of Life
(SDOH, disabilities, risk factors)
What is Quality
- Refers to how likely our interventions are to cause a change or some sort of positive outcome
6 Aims of Quality Improvement and Redesign of Healthcare System
Safe - No one should be harmed
Effective - Should match science, with no underuse or overuse of techniques (Every elderly heart patient who would benefit from beta blockers should get them but no child with a simple ear infection should get advanced antibiotics)
Patient Centered - Cultural and social needs should be respected and patients should play an active role in their decision making care.
Timely - Prompt attention benefits both patient and caregiver
Equitable - Race, ethnicity, gender, and income should not prevent anyone from high quality healthcare.
Efficient - Constantly seek to reduce waste in healthcare hence cost of supplies, ideas, time and opportunities
Patient Protection and Affordable Care Act
- Quality affordable care for all Americans
- Role of Public Programs
- Improve quality and efficiency of healthcare
- Prevent chronic disease and improve public health
- Healthcare workforce
- Transparency and Program Integrity
- Improve access to Innovative Medical Therapies
- Community Living Assistance Services and Support
- Revenue Provisions
