The ongoing history of quality improvement in medical care in one of great theories and hypotheses which seldom seem to pan out in ultimate health outcomes. A study in the New England Journal of Medicine deals with one such effort. (NEJM Article) A heart attack is typically due to constricted blood flow within the heart. For a victim, getting to a setting where the affected artery can be opened more fully may be critical. Therefore, many quality improvement programs have set a goal of a “door to balloon” time of less than 90 minutes. Pay-for-performance and quality reporting programs frequently use this measure. A large consortium of health systems provided the data used in the study from a registry, with a total of over 95,000 patients examined for the time period 2005-09. Average door-to-balloon time decreased from 83 minutes in 2005-06 to 67 minutes in 2008-09, demonstrating the effect of the quality improvement programs. The in-hospital mortality rate, however, barely budged, from 4.8% to 4.7%, a non-significant change. Over 80% of patients were getting to the hospital in less than 90 minutes, but there mortality was unchanged. Getting to the hospital in less than 90 minutes was clearly associated with lower mortality, but getting more patients there faster did not change overall mortality. It may be that simply getting someone to the hospital faster isn’t the major factor in survival, other circumstances may be more important. In any event, all the effort and money spent on this goal may not be getting the best bang for the buck.
✅ Subscribe via Email
About this Blog
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at [email protected].
Healthy Skeptic Podcast
This is an outstanding report on total global drug spending and trends, with projections out to 2025. It helps you understand this important area of health care, which does much...
June 1, 2021
MedPAC 2019 Report to Congress
June 18, 2019
Mental health company Headway makes, well, headway, by raising an impressive $125 million round of new capital. The company connects patients with mental health providers and facilitates providers working with...
October 11, 2023
Two health care firms owned by private equity firms are merging in a transaction supposedly valued at $3 billion. HealthComp administers self-funded plans for employers and other groups and Virgin...
September 27, 2023
NextGen, an electronic medical records firm, is being put out of its public company misery, as a PE firm will pay $1.6 billion for the one-time high-flier.
September 7, 2023
Access ACO Care Management Chronic Disease Comparative Effectiveness Consumer Directed Health Consumers Devices Disease Management Drugs EHRs Elder Care End-of-Life Care FDA Financings Genomics Government Health Care Costs Health Care Quality Health Care Reform Health Insurance Health Insurance Exchange HIT HomeCare Hospital Hospital Readmissions Legislation M&A Malpractice Meaningful Use Medicaid Medical Care Medicare Medicare Advantage Mobile Pay For Performance Pharmaceutical Physicians Providers Regulation Repealing Reform Telehealth Telemedicine Wellness and Prevention Workplace