Perspectives: Quality Care as a Driver for Health System Change
Quality measurement in health care has always been difficult and expensive. In my 30 years in medicine, the focus has been geared more towards measuring outcomes from an acute care perspective rather than quality from the point of view of the individual. For example, documenting hemoglobin A1C levels or body mass index scores may measure clinical quality, yet these markers reveal little about a person’s daily living needs and how decisions about their care are made.Date Updated: 03/11/2014
Over the years, quality has been limited to three distinct buckets:
- Is the environment where care is delivered safe and staffed appropriately?
- Are the technical aspects of care consistent with data driven guidelines?
- Are patients satisfied with the service they receive?
The problem is that these measures too often do not reflect the totality of the experience of the person receiving care. While these elements are important and necessary, they do not provide a complete look at quality, particularly for those who have serious chronic illness or functional limitations.
High quality, cost effective health care delivery is all about targeting – the right care, by the right provider, at the right time, in the right place, and for the right cost. It sounds straightforward, almost easy. The challenge to getting it right is understanding the range of variables in a person’s life that drive health care use and costs. Find out more in this week’s Perspectives.
Chances are you know and love an older person with needs. Maybe it’s that neighbor of yours whose trash cans you help bring in once a week. Perhaps it’s your grandparent or even a parent who needs help understanding the bills or getting the groceries up the stairs. The reality is the population of older adults in this country is growing rapidly due in large part to the aging of baby boomers – a demographic shift that affects us all. Advancements in health care and technology have also spurred this phenomenon, yet we know that a longer life also brings a greater likelihood of facing multiple chronic health conditions and possibly needing help with everyday activities.
In this Perspectives, Dr. Chernof reflects on the Foundation’s presence at the 2012 American Society on Aging Conference and how improving long-term care in California will require the long-term strategies and dedication of a social movement.