Health and Medical News and Resources

General interest items edited by Janice Flahiff

Performance Measurement – Converting Practice Guidelines Into Quality Measure

English: California OPA Health Care Quality Re...


Excerpts from the 19 December blog item by Ha-Vinh at Health Services Authors

Performance incentives have been recently adopted in France by the national health care insurer to remunerate French Doctors. In Health care, when one can not measure outcomes one measures process. But a good process for an individual patient doesn’t reflect necessarily a good process for the average patient studied by the evidence-based medical research. In a precedent post I presented what the heterogeneity of treatment effect means. In the present post I will try to highlight where stands the fundamental difference between professional guidelines and quality assessment tools of physician practice. Guidelines stem from the average patient. A quality assessment tool assesses the individual patient dealing with the heterogeneity or deviation around the mean value. From now on, given the use of guidelines made by health policy makers to evaluate health care professionals, it becomes a priority goal for searchers to take into account this use when writing their guidelines. For that purpose they should more insist on the heterogeneity of their results and perform sub group analysis across the different risk level of disease to which their studied subjects are exposed. They should accurately determine if their recommendations are applicable to subjects with multiple co morbidities. That is only at this condition that guideline will coincide with a sound balanced quality assessment tool for physician practice…

Read the entire article here

Comment I left at this blog item..

Thank you…it reinforces my beliefs about practice guidelines, emphasis on guidelines!
It is good to measure compliance, and have incentives for performance…
Although generalizations can be made about how to best treat diseases/conditions…at the end of the day…it is people, not diseases/conditions..that are the focus of any good health care system…and heterogeneity of treatment effect is an important facet of treating the whole person, not just the disease/condition..



December 20, 2011 - Posted by | health care | , , ,

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