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Quality Spine Care: Healthcare Systems, Quality Reporting, and Risk Adjustment de John Ratliff

Quality Spine Care: Healthcare Systems, Quality Reporting, and Risk Adjustment

Editat de John Ratliff, Todd J. Albert, Joseph Cheng, Jack Knightly
en Limba Engleză Hardback – 7 noi 2018

Structura acestui tratat este riguros organizată pentru a ghida cititorul de la fundamentele istorice ale calității în medicină către aplicațiile clinice și administrative complexe din prezent. Quality Spine Care debutează cu o analiză a standardizării educației medicale și evoluția evaluării calității în chirurgia coloanei, continuând cu o secțiune tehnică esențială despre alegerea metricilor de evaluare și importanța Patient Reported Outcomes. Observăm o atenție deosebită acordată registrelor naționale și internaționale, volumul oferind o perspectivă globală rară prin compararea sistemelor de sănătate din America de Nord, Europa și Asia.

Abordarea este una clinică și pragmatică, axată pe rezolvarea lipsei de consens actuale în ceea ce privește măsurarea valorii actului medical. Autorii, sub coordonarea editorilor John Ratliff și Todd J. Albert, explorează detaliat metodologiile de ajustare a riscurilor, un element critic pentru o raportare corectă care să nu penalizeze cazurile complexe. Apreciem integrarea unor capitole dedicate implementării practice a acestor metrici în fluxul de lucru zilnic, exemplificată prin modelele de succes ale unor giganți precum Kaiser Permanente.

Manual de referință comparabil cu Quality and Regulation in Health Care de Robert Dingwall, dar actualizat conform ghidurilor și reglementărilor din 2019, acest volum se distinge prin focalizarea strictă pe domeniul neurochirurgiei și ortopediei coloanei vertebrale. În timp ce lucrări precum Quality Measures de Deeb N. Salem oferă o perspectivă generală asupra decalajului dintre politici și practică, Quality Spine Care furnizează instrumente specifice pentru chirurgul coloanei, explicând cum codificarea și raportarea calității influențează direct rambursarea și sustenabilitatea practicii medicale.

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Specificații

ISBN-13: 9783319979892
ISBN-10: 3319979892
Pagini: 547
Ilustrații: XXI, 405 p. 45 illus., 44 illus. in color.
Dimensiuni: 155 x 235 x 20 mm
Greutate: 0.82 kg
Ediția:1st ed. 2019
Editura: Springer International Publishing
Colecția Springer
Locul publicării:Cham, Switzerland

De ce să citești această carte

Recomandăm această lucrare neurochirurgilor și chirurgilor ortopezi care doresc să înțeleagă mecanismele economice și administrative ce guvernează medicina modernă. Cititorul câștigă o înțelegere clară a modului în care calitatea raportată se traduce în valoare financiară și clinică, primind un fundament solid pentru optimizarea propriei practici conform standardelor internaționale de „Centers of Excellence”. Este o resursă indispensabilă pentru șefii de secție și administratorii de spitale specializate.

Despre autor

Editorii volumului, printre care se numără John Ratliff și Todd J. Albert, sunt figuri proeminente în neurochirurgie și ortopedie, cu o vastă experiență în managementul academic și clinic al patologiilor coloanei vertebrale. Todd J. Albert este recunoscut la nivel internațional pentru contribuțiile sale în chirurgia cervicală și spinală complexă, ocupând funcții de conducere în instituții medicale de elită. Expertiza lor combinată asigură o perspectivă autoritară asupra intersecției dintre excelența chirurgicală, politicile de sănătate publică și sistemele de raportare a calității, adaptată cerințelor actuale ale Springer.

Descriere scurtă

Quality reporting is a rapidly growing area.  Each year, new regulations in the US from the Council of Medicare and Medicaid Services make quality reporting a larger factor in determining reimbursement practices. Quality metrics are common parts of European clinical practice.  Value of care is a focus of all payers, with specific interest directed at assessing the quality of care provided by a given healthcare team.  While there are many publications in this space, no text has sought to provide an overview of quality in spine care.
 
Quality measurement and quality reporting are ever growing aspects of the healthcare environment. Quality assessment is valuable to all healthcare stakeholders:  patients, physicians, facilities, and payers. Patients are drawn to facilities that provide high value care; public reporting systems and grading systems for hospitals offer one opinion with regard to “high quality care.”  Most physicians email inboxes are inundated with offers of recognition for being a “Top Doc” for a nominal fee.  Some payers offer incentives to patients who chose to be treated at “Centers of Excellence” or similar facilities; the definition of “Excellence” may be unclear.  

There is little consensus on how to measure quality, how to incorporate patient and procedure factors and achieve accurate risk adjustment, and how to define value of care.  Regardless of these challenges, regulatory efforts in the US, as well as numerous international efforts, make quality assessment and quality reporting an important part of physician behaviour.   

Physician and facility reimbursement for procedures are often tied to quality metrics. Spine procedures are costly, elective, and are a focus of many payer-based programs.  Hence, spine care is often a focus of quality reporting efforts.  This text summarizes the state of the art with regard to quality measurement, reporting, and value assessment in spine care.  We will review quality reporting in the US and internationally.   Chapters will outline how quality improvement efforts have achieved success in hospital systems.  The reader will be provided with insights in how to achieve success incorporating quality metrics into spine care.

Features:

1.  Illustrates the state of the art in spine quality reporting: There is no text that thoroughly addresses quality assessment and quality reporting in spine care; there are, however, numerous articles in this space.  This book provides a definitive text covering the state of the art for quality reporting in spine care and will be of value to the international orthopedic and neurosurgical spine community.

2.  Provides insight on quality reporting in different healthcare systems:   The text will allow for comparison of different quality reporting systems from different health care systems.  This will provide practitioners with insight into the strengths and weaknesses of different approaches to quality reporting, and may drive improvement in quality assessment and reporting systems.  A single text that features review of US, European, and Australia/Asian health care systems’ quality reporting is novel and will be thought provoking for readers.  

3.  Describes the US and international Healthcare reimbursement systems:  Practicing physicians are provided with little information and less insight into the vagaries of the US and other healthcare systems.  The text will provide insight into code development, valuation, and how quality reporting affects physician reimbursement

4.  Explains risk adjustment:  Appropriate risk adjustment and assessing patient and procedure factors that may impact quality reporting are invaluable to accurate quality measurement.  The text will review risk adjustment, different approaches to risk assessment/mitigation, and provide physicians with insights into appropriate measures to capture in their clinical practices

5.  Provides a foundation for improved quality assessment in spine care:  While there are many disparate elements and differing approaches to capturing spine quality metrics, no definitive text has attempted to summarize these efforts in a single volume.  By synthesizing these variable approaches, the reader may be provided with insights into superior approaches to quality assessment and a foundation will be provided for improving healthcare systems.

Cuprins

Historical Aspects of Quality in Healthcare.- Quality and Standardization of Medical Education.- The History of Quality Assessment in Spine Care.- Choice of Quality Metrics for Assessment of the Spine Patient.- Patient Reported Outcomes.- Registries in Spine Care, United States.- Registries in Spine Care, UK and Europe.- Concepts of Risk Stratification in Measurement and Delivery of Quality.- Risk Adjustment Methodologies.- Healthcare Systems in the United States.- The National Health Service (NHS) in England: Trying to Achieve Value Based Health Care.- Quality Spine Care in Australasia.- Healthcare Systems: India.- Healthcare Systems and Quality Assessment of Spine Care in Japan.- Overview of Healthcare System in China.- Conditions of Care and Episode Groups.- Aligning Healthcare Systems.- Building Quality Metrics into a Practice.- Impact of Quality Assessment on Clinical Practice, Intermountain Healthcare.- Impact of Quality Assessment on Clinical Practice, Kaiser Permanente.- How Quality is Assessed in Insurance Markets.- Centers of Excellence and Payer Defined Quality Assessment.- Reporting Quality Results.- Achieving Success in Quality Reporting.

Recenzii

“The text appears intended for practicing neurosurgeons and orthopedic surgeons specializing in spine surgery, as well as clinical practitioners, hospital administrators, and other individuals directly involved in the care of patients with spinal disorders. … ‘Quality Spine Care: Healthcare Systems, Quality Reporting, and Risk Adjustment’ is very well written. Its concise chapters will aid any spine surgeon in optimizing one’s practice to focus on quality and value.” (Scott J. Raffa and Michael Y. Wang, Neurosurgery, Vol. 85 (4), October, 2019)

“The audience is practitioners, surgeons, public health specialists, and even healthcare administrators. The book meets the objective of addressing these audiences and is relatively straightforward in its explanations. … This is a high‐quality book that provides a great recapitulation of quality assessment in spine care. It is thefirst book its kind and is a great focused review of this topic.” (Ankit I Mehta, Doody's Book Reviews, July 05, 2019)

Notă biografică

John Ratliff
Department of Neurosurgery
Stanford University
Stanford, CA
USA

Todd J. Albert
Hospital for Special Surgery
New York, NY
USA

Joseph Cheng
Department of Neurosurgery
University of Cincinnati College of Medicine
Cincinnati, OH
USA

John Knightly
Neurosurgery, Atlantic Neurosurgical Specialists
Morristown, NJ
USA

Textul de pe ultima copertă

This book provides a succinct overview of a variety of aspects of quality that is absent from other texts that cover the technical aspects of operative spine care. Readers are provided with insight and comparisons of different quality reporting systems across different health care systems, while also discussing the different strengths and weaknesses therein. The book summarizes state-of-the-art quality measurement and value assessment in spine care while reviewing quality reporting in the US and internationally. Chapters also outline how quality improvement efforts achieved success in hospital systems. 

Quality Spine Care: Healthcare Systems, Quality Reporting, and Risk Adjustment provides surgeons and practitioners with insight into the challenging aspects of healthcare delivery and quality assessment related to spine care.