10.2 Health Outcomes and Quality Care

Question 1

Health Outcomes

Answer 1

• End results that follow some kind of healthcare provision, treatment, or intervention and may describe patient’s condition or health status.

Question 2

How to measure a Health Outcome

Answer 2

• 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

Question 3

How do we measure health of individuals

Answer 3

• Lab Values
• Physical Exams
• Presence of Disease
• Screenings

Question 4

How do we Measure Health of a Population

Answer 4

• Mortality Rates
• Morbidity Rates
• Presence of disease (%)
• Life expectancy
• Quality of Life

Question 5

Measure Health Depending the Stage of Lifespan

Answer 5

Childhood - Growth and development, socialization, school skills, learning skills

Adulthood - Absence of disease, healthy relationships, societal performance

Question 6

OUTCOME METRICS FOR POPULATION HEALTH

Question 7

Life Expectancy at Birth

Answer 7

• The average number of years a newborn is expected to live if mortality patterns at the time of birth remain constant in the future

Question 8

Life Expectancy at a Later Point

Answer 8

• Prediction of how life expectancy might change over time

Question 9

Measurement of Premature Death

Answer 9

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

Question 10

Crude Mortality

Answer 10

• Total number of deaths to residents in a specific geographical area divided by total population of the area

Question 11

Age Adjusted Mortality

Answer 11

• Death rates that control the effect of differences in population of age distributions

Question 12

Characteristic Adjusted Mortality

Answer 12

• Death rates based on a defined characteristic

Question 13

OUTCOME METRICS

Answer 13

• Do not tell us overall health of population or account for cultural differences

Question 14

US POPULATION METRIC SOURCSE

Answer 14

• 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

Question 15

Sources of Population Health Outcome Data

Answer 15

• ANA National Database and Nursing Quality Indicators
• Virginia Department of Health
• HP2020
• AHRQ (Agency for Healthcare Research and Quality)
• National Healthcare Quality Report

Question 16

Measure of Health, Function, Subjective Well-being

Answer 16

• 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

Question 17

Why Measure Health Outcomes

Answer 17

• To know if interventions are working
• To examine how well we are helping a population
• Examine quality of methods

Question 18

Who What When Approach

Answer 18

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)

Question 19

Structure, Process, Outcome Approach

Answer 19

• 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

Question 20

Structure

Answer 20

• Infrastructure
• Demographics
• Technology
• Education
• Facilities
  (Number and type of health services/staff, and health service utilization)

Question 21

Process

Answer 21

• Diagnosis
• Treatment
• Appropriateness
• Process of Care
• Resources Requirements

Question 22

Outcomes

Answer 22

• Mortality
• Morbidity
• Cost
• Factors Creating Cost
• Quality of Life
  (SDOH, disabilities, risk factors)

Question 23

What is Quality

Answer 23

• Refers to how likely our interventions are to cause a change or some sort of positive outcome

Question 24

6 Aims of Quality Improvement and Redesign of Healthcare System

Answer 24

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

Question 25

Patient Protection and Affordable Care Act

Answer 25

• 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