Outcomes Measurements: The Road from Volume to Value
Grand Rounds in Urology Contributing Editor Neil H. Baum, MD, Professor of Urology at Tulane Medical School, discusses the shifting paradigm in healthcare from the volume of services provided to the value of services. He describes outcome management, how to get started, and challenges to this approach. This client-centric approach to healthcare delivery redefines value to equal health outcomes that matter to the patient divided by cost. To implement this approach, Dr. Baum advises starting with conditions that have quantifiable measures such as radical prostatectomy, BPH, or ureteral stones. Outcomes have historically been measured by mortality, morbidity, readmission rate, and length of stay, but the new standard will consider patient satisfaction, which can be measured by looking at the length of time it took to for the patient to make an appointment, time spent waiting in the exam room, whether their questions were answered, and if they received a follow-up on test results. He notes that AUA guidelines can also provide a rubric for outcomes that are important to both the physician and the patient. Dr. Baum underscores that patients who have a positive experience have better clinical outcomes and improved quality of life. Similarly, outcome management is proactive and promotes innovation with the goal of improving care.
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