Two Johns Hopkins researchers introduce the idea that more attention should be given to the quality of measurement tools used to praise and punish a hospital.
“People want to compare hospitals, but if the science can’t keep up, maybe we’re doing more harm than good when we report certain kinds of data,” Elliott R. Haut, MD, stated in a press release,
Haut discusses the idea of “surveillance bias” in stopping deep venous thrombosis (DVT); the more tests done for DVT, the higher the DVT rate for a hospital. “Reporting a DVT rate, doesn’t tell much about hospital quality, since it doesn’t delineate whether the hospital is ignoring a potential complication or successfully preventing one,” Haut says.
Not only do potential patients look at these ratings and make their decisions based on numbers that may be worthless, but hospitals will not be paid for certain tests based on these ratings. This idea Haut calls a “perverse incentive,” if a hospital doesn’t look for DVT and doesn’t find one, they will still be paid, but if a hospital aggressively tests for DVTs and find them, they won’t be paid.
“You have to make sure your measures are fair and that the benefits of reporting adverse outcomes outweigh the risks of unfairly harming hospitals, because these measures have unintended consequences,” Haut stated.