Valor na saúde e incentivos

Dois textos muito interessantes sobre a importância do valor na área da saúde e sobre a diferença entre resultados vs actividades.

• "Understanding Health Care’s Short-Termism Problem"

"A value-driven payment strategy would not pay hospitals more for using robotic surgery but would certainly pay hospitals than produced better outcomes more. Often this strategy would involve not paying for expensive treatments that increase survival by a day or two, or incrementally, but have no long-term benefit. This would encourage adoption of technologies that work and penalize those that don’t work but whose generous reimbursement makes them highly profitable."

• "What Has the Biggest Impact on Hospital Readmission Rates" (uma pessoa descobre cada coisa... a quantidade de atributos luxuosos e ao lado do essencial, para melhorar estatísticas sem ir ao assunto. Faz-me lembrar a clínica dos anos 90 que, em vez de reduzir o tempo de espera para atendimento, optou por televisão e outros ardis para enganar a passagem do tempo)

"In fact, the results indicate that a hospital would, on average, reduce its readmission rate by 5% if it were to prioritize communication with the patients in addition to complying with evidence-based standards of care
...
Faced with the ultimatum from CMS in their recent value-based-purchasing reform, hospitals are rethinking their strategies to improve their HCAHPS scores aimed at measuring patient experience. Many are doing so by investing in superficial amenities or by investing in technologies that allow caregivers to track and respond to a patient’s call for help. This is certainly not a bad idea given the cultural difficulties involved in changing their caregivers’ mindset to improve their interpersonal communication skills. But will all these material assets substitute for a change in culture and solve the problems in the delivery of care? Our research suggests they won’t.
...
when the process-of-care quality is high, improving on the communication-focused dimension has a much stronger effect on reducing readmission rates when compared to improving on the response-focused patient-experience dimension."