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Putting health care providers in the information mirror: using data to improve the efficiency and accessibility of care.
Lagoe, R.J., Westert, G.P., Aspling, D. Putting health care providers in the information mirror: using data to improve the efficiency and accessibility of care. European Journal of Public Health: 2003, 13(4 sup) 81. Abstract van de 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italië op 20-22 November 2003.
Aim: To study whether or not feed back of information to health care providers changes their practice patterns and improves the efficiency of hospital inpatient care and the accessibility of emergency departments to ambulances. Methods: Community wide hospital utilization data from the metropolitan area of four hospitals in Syracuse (New York, USA) is used covering 70,000 discharges and 140,000 emergency department visits annually. Mirror information includes monthly distribution of utilization data (e.g. admissions, lengths of stay and readmissions) for physicians, home care agencies, nursing homes, and emergency department data. Also severity adjusted length of stay data for individual physicians practicing in adult medicine and adult surgery was used. The project (implementation between 2000 and 2002) used the above information to produce a change in behavior among providers to encourage more efficient utilization and greater accessibility of emergency departments. This behavioral change, reinforced by reports on a monthly and daily basis, stimulated competition among hospitals to achieve these objectives. Results: The project successfully developed an interest in utilization and readmissions among the four hospitals. Between 2000 and 2002, medical/surgical lengths of stay were reduced by 0.5 days, eliminating over 10,000 patient days. Despite the decrease in patient days, hospital readmissions within 7 days were unchanged. An additional reduction of 10 percent in length of stay for adult medicine occurred between January and March 2003 compared with the same period in 2002. The widespread provision of mirror information also brought about reduction of emergency department ambulance diversion hours by 50 percent between 2000 and 2002. This reduction occurred as the number of emergency department visits increased by 4 percent and the number of ambulance transports increased by 2 percent. Conclusions: The project demonstrated that widespread periodic distribution of hospital utilization data could bring about positive changes in the utilization and accessibility of health care. (aut.ref)
Aim: To study whether or not feed back of information to health care providers changes their practice patterns and improves the efficiency of hospital inpatient care and the accessibility of emergency departments to ambulances. Methods: Community wide hospital utilization data from the metropolitan area of four hospitals in Syracuse (New York, USA) is used covering 70,000 discharges and 140,000 emergency department visits annually. Mirror information includes monthly distribution of utilization data (e.g. admissions, lengths of stay and readmissions) for physicians, home care agencies, nursing homes, and emergency department data. Also severity adjusted length of stay data for individual physicians practicing in adult medicine and adult surgery was used. The project (implementation between 2000 and 2002) used the above information to produce a change in behavior among providers to encourage more efficient utilization and greater accessibility of emergency departments. This behavioral change, reinforced by reports on a monthly and daily basis, stimulated competition among hospitals to achieve these objectives. Results: The project successfully developed an interest in utilization and readmissions among the four hospitals. Between 2000 and 2002, medical/surgical lengths of stay were reduced by 0.5 days, eliminating over 10,000 patient days. Despite the decrease in patient days, hospital readmissions within 7 days were unchanged. An additional reduction of 10 percent in length of stay for adult medicine occurred between January and March 2003 compared with the same period in 2002. The widespread provision of mirror information also brought about reduction of emergency department ambulance diversion hours by 50 percent between 2000 and 2002. This reduction occurred as the number of emergency department visits increased by 4 percent and the number of ambulance transports increased by 2 percent. Conclusions: The project demonstrated that widespread periodic distribution of hospital utilization data could bring about positive changes in the utilization and accessibility of health care. (aut.ref)