PDF(Pubmed)
Abstract：
US hospitals report data on many health care quality metrics to government and independent health care rating organizations, but the annual cost to acute care hospitals of measuring and reporting quality metric data, independent of resources spent on quality interventions, is not well known.
To evaluate externally reported inpatient quality metrics for adult patients and estimate the cost of data collection and reporting, independent of quality-improvement efforts.
Retrospective time-driven activity-based costing study at the Johns Hopkins Hospital (Baltimore, Maryland) with hospital personnel involved in quality metric reporting processes interviewed between January 1, 2019, and June 30, 2019, about quality reporting activities in the 2018 calendar year.
Outcomes included the number of metrics, annual person-hours per metric type, and annual personnel cost per metric type.
A total of 162 unique metrics were identified, of which 96 (59.3%) were claims-based, 107 (66.0%) were outcome metrics, and 101 (62.3%) were related to patient safety. Preparing and reporting data for these metrics required an estimated 108 478 person-hours, with an estimated personnel cost of $5 038 218.28 (2022 USD) plus an additional $602 730.66 in vendor fees. Claims-based (96 metrics; $37 553.58 per metric per year) and chart-abstracted (26 metrics; $33 871.30 per metric per year) metrics used the most resources per metric, while electronic metrics consumed far less (4 metrics; $1901.58 per metric per year).
Significant resources are expended exclusively for quality reporting, and some methods of quality assessment are far more expensive than others. Claims-based metrics were unexpectedly found to be the most resource intensive of all metric types. Policy makers should consider reducing the number of metrics and shifting to electronic metrics, when possible, to optimize resources spent in the overall pursuit of higher quality.
To evaluate externally reported inpatient quality metrics for adult patients and estimate the cost of data collection and reporting, independent of quality-improvement efforts.
Retrospective time-driven activity-based costing study at the Johns Hopkins Hospital (Baltimore, Maryland) with hospital personnel involved in quality metric reporting processes interviewed between January 1, 2019, and June 30, 2019, about quality reporting activities in the 2018 calendar year.
Outcomes included the number of metrics, annual person-hours per metric type, and annual personnel cost per metric type.
A total of 162 unique metrics were identified, of which 96 (59.3%) were claims-based, 107 (66.0%) were outcome metrics, and 101 (62.3%) were related to patient safety. Preparing and reporting data for these metrics required an estimated 108 478 person-hours, with an estimated personnel cost of $5 038 218.28 (2022 USD) plus an additional $602 730.66 in vendor fees. Claims-based (96 metrics; $37 553.58 per metric per year) and chart-abstracted (26 metrics; $33 871.30 per metric per year) metrics used the most resources per metric, while electronic metrics consumed far less (4 metrics; $1901.58 per metric per year).
Significant resources are expended exclusively for quality reporting, and some methods of quality assessment are far more expensive than others. Claims-based metrics were unexpectedly found to be the most resource intensive of all metric types. Policy makers should consider reducing the number of metrics and shifting to electronic metrics, when possible, to optimize resources spent in the overall pursuit of higher quality.
摘要：
■美国医院向政府和独立的医疗保健评级组织报告了许多医疗保健质量指标的数据，但是急性护理医院测量和报告质量度量数据的年度成本，独立于花费在质量干预上的资源，不是众所周知的。
■评估外部报告的成年患者住院质量指标，并估计数据收集和报告的成本，独立于质量改进工作。
■约翰·霍普金斯医院的回顾性时间驱动的基于活动的成本核算研究(巴尔的摩，马里兰州）与参与质量度量报告流程的医院人员在2019年1月1日至2019年6月30日之间就2018日历年的质量报告活动进行了访谈。
■结果包括指标数量，每个公制类型的年度人时数，和每公制类型的年度人员成本。
■总共确定了162个独特的指标，其中96人(59.3%)是基于索赔的，107（66.0%）是结果指标，101例(62.3%)与患者安全相关.为这些指标准备和报告数据需要估计108478个小时，估计人员成本为5038218.28美元（2022美元），外加602730.66美元的供应商费用。基于索赔的(96个度量；每年每个度量37553.58美元)和图表抽象的(26个度量；每年每个度量33871.30美元)度量使用的每个度量资源最多，而电子指标的消耗要少得多(4个指标；每年每个指标1901.58美元)。
■大量资源专门用于质量报告，一些质量评估方法比其他方法昂贵得多。意外发现基于声明的度量是所有度量类型中资源最密集的。政策制定者应考虑减少指标数量,转向电子指标,如果可能,优化资源支出，追求整体更高的质量。
■评估外部报告的成年患者住院质量指标，并估计数据收集和报告的成本，独立于质量改进工作。
■约翰·霍普金斯医院的回顾性时间驱动的基于活动的成本核算研究(巴尔的摩，马里兰州）与参与质量度量报告流程的医院人员在2019年1月1日至2019年6月30日之间就2018日历年的质量报告活动进行了访谈。
■结果包括指标数量，每个公制类型的年度人时数，和每公制类型的年度人员成本。
■总共确定了162个独特的指标，其中96人(59.3%)是基于索赔的，107（66.0%）是结果指标，101例(62.3%)与患者安全相关.为这些指标准备和报告数据需要估计108478个小时，估计人员成本为5038218.28美元（2022美元），外加602730.66美元的供应商费用。基于索赔的(96个度量；每年每个度量37553.58美元)和图表抽象的(26个度量；每年每个度量33871.30美元)度量使用的每个度量资源最多，而电子指标的消耗要少得多(4个指标；每年每个指标1901.58美元)。
■大量资源专门用于质量报告，一些质量评估方法比其他方法昂贵得多。意外发现基于声明的度量是所有度量类型中资源最密集的。政策制定者应考虑减少指标数量,转向电子指标,如果可能,优化资源支出，追求整体更高的质量。
