Tarik K Yuce, Cynthia Barnard, Leah Hobson, Karl Y Bilimoria
{"title":"公开报道的医院评级系统的不完善科学:信用评级机构的经验教训。","authors":"Tarik K Yuce, Cynthia Barnard, Leah Hobson, Karl Y Bilimoria","doi":"10.1097/QMH.0000000000000378","DOIUrl":null,"url":null,"abstract":"<p><p>The number of publicly available hospital quality rating systems has substantially increased over the past 2 decades. These rating systems are meant to provide patients, clinicians, and payers with relevant information to select and pay differentially for better quality of care. However, there is evidence of inconsistency, unreliability, and bias in current hospital quality rating systems. Financial ratings are similarly intended to enable investors to identify stronger companies (as investment targets), and these rating systems could provide insight into strategies to improve hospital quality ratings. We evaluate the credit rating methodologies of Standard & Poor's, Moody's, and Fitch Group and propose principles to improve hospital quality rating systems through better standardized measures and the use of external audits of source data. Emulating key features of credit rating systems may advance the delivery of meaningful hospital quality ratings.</p>","PeriodicalId":20986,"journal":{"name":"Quality Management in Health Care","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Imperfect Science of Publicly Reported Hospital Rating Systems: Lessons From Credit Rating Agencies.\",\"authors\":\"Tarik K Yuce, Cynthia Barnard, Leah Hobson, Karl Y Bilimoria\",\"doi\":\"10.1097/QMH.0000000000000378\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The number of publicly available hospital quality rating systems has substantially increased over the past 2 decades. These rating systems are meant to provide patients, clinicians, and payers with relevant information to select and pay differentially for better quality of care. However, there is evidence of inconsistency, unreliability, and bias in current hospital quality rating systems. Financial ratings are similarly intended to enable investors to identify stronger companies (as investment targets), and these rating systems could provide insight into strategies to improve hospital quality ratings. We evaluate the credit rating methodologies of Standard & Poor's, Moody's, and Fitch Group and propose principles to improve hospital quality rating systems through better standardized measures and the use of external audits of source data. Emulating key features of credit rating systems may advance the delivery of meaningful hospital quality ratings.</p>\",\"PeriodicalId\":20986,\"journal\":{\"name\":\"Quality Management in Health Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2023-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Quality Management in Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/QMH.0000000000000378\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/7/29 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Quality Management in Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QMH.0000000000000378","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/7/29 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
The Imperfect Science of Publicly Reported Hospital Rating Systems: Lessons From Credit Rating Agencies.
The number of publicly available hospital quality rating systems has substantially increased over the past 2 decades. These rating systems are meant to provide patients, clinicians, and payers with relevant information to select and pay differentially for better quality of care. However, there is evidence of inconsistency, unreliability, and bias in current hospital quality rating systems. Financial ratings are similarly intended to enable investors to identify stronger companies (as investment targets), and these rating systems could provide insight into strategies to improve hospital quality ratings. We evaluate the credit rating methodologies of Standard & Poor's, Moody's, and Fitch Group and propose principles to improve hospital quality rating systems through better standardized measures and the use of external audits of source data. Emulating key features of credit rating systems may advance the delivery of meaningful hospital quality ratings.
期刊介绍:
Quality Management in Health Care (QMHC) is a peer-reviewed journal that provides a forum for our readers to explore the theoretical, technical, and strategic elements of health care quality management. The journal''s primary focus is on organizational structure and processes as these affect the quality of care and patient outcomes. In particular, it:
-Builds knowledge about the application of statistical tools, control charts, benchmarking, and other devices used in the ongoing monitoring and evaluation of care and of patient outcomes;
-Encourages research in and evaluation of the results of various organizational strategies designed to bring about quantifiable improvements in patient outcomes;
-Fosters the application of quality management science to patient care processes and clinical decision-making;
-Fosters cooperation and communication among health care providers, payers and regulators in their efforts to improve the quality of patient outcomes;
-Explores links among the various clinical, technical, administrative, and managerial disciplines involved in patient care, as well as the role and responsibilities of organizational governance in ongoing quality management.