By Matt Kuhrt
A study that compared preventable hospital admissions independently identified by both physicians and the standardized Prevention Quality Indicator (PQI) showed a level of agreement "no different than what would be expected by chance," according to an article in Medscape Medical News.
The drive to curb healthcare costs by improving the overall quality of care has led providers to look more closely at cases where patients have been admitted to a hospital for conditions that could have been prevented by earlier treatment. Questions linger about the reliability of readmission rates as a measure of quality, per previous reporting by FierceHealthcare, further underscoring tensions between administrators and physicians as they settle on appropriate metrics for value-based payment models.
The PQI represents a set of standardized measures developed by the Agency for Healthcare Research and Quality and adopted by some pay-for-performance programs in order to target and reduce preventable admissions. Of the 23 percent of cases the PQI identified as preventable, independent physicians disagreed with 56 percent. Cases where the physicians and the PQI agreed about preventability made up a mere 10 percent of the overall sample.
The study findings indicate a need for data that are both accurate and comparable. While physicians' reviews of the data might make for a more accurate assessment, the study said it's more difficult to generate comparable data for comparison with these methods, given that they are not easy to standardize across healthcare institutions.
The PQI offers standardized data, but it "cannot identify an appropriate rate for hospital admissions within a given population," the authors write, "therefore it cannot serve as a tool to help hospitals focus their prevention efforts."