Drozda feels we are "edging slowly to a deeper understanding", but Oliver goes straight to the point - readmission rates can tell us nothing about quality!
Just like referral rates and prescribing rates used as performance indicators, the flawed premise is that rates are related to quality, when manifestly they are not. An average rate can easily conceal the worst quality in practice, but remains the fetish of performance monitors!! Rates are foisted upon us because they are easily obtained. What we really need are measures of appropriate readmission, quality assessments of indicated referral, measures of the value added by prescriptions, and in this readmissions study - measures of whether they achieved better outcomes than the alternatives available at the time!
Wasn't it Einstein who said "What counts doesn't matter, whilst what matters doesn't count"!
Rapid Response:
Re: Readmission rates
Drozda feels we are "edging slowly to a deeper understanding", but Oliver goes straight to the point - readmission rates can tell us nothing about quality!
Just like referral rates and prescribing rates used as performance indicators, the flawed premise is that rates are related to quality, when manifestly they are not. An average rate can easily conceal the worst quality in practice, but remains the fetish of performance monitors!! Rates are foisted upon us because they are easily obtained. What we really need are measures of appropriate readmission, quality assessments of indicated referral, measures of the value added by prescriptions, and in this readmissions study - measures of whether they achieved better outcomes than the alternatives available at the time!
Wasn't it Einstein who said "What counts doesn't matter, whilst what matters doesn't count"!
Will we ever learn ?
Competing interests: No competing interests