180 likes | 308 Views
MQMS: Patient Safety Among Medicare Beneficiaries. Arnold Chen, M.D., M.Sc. (MPR) David Hunt, M.D. (CMS) Sheila Roman, M.D., M.P.H. (CMS) Lein Han, Ph.D. (CMS) Neil Gittings, M.A. (CMS) June 2004. Study Objectives.
E N D
MQMS: Patient Safety Among Medicare Beneficiaries Arnold Chen, M.D., M.Sc. (MPR) David Hunt, M.D. (CMS) Sheila Roman, M.D., M.P.H. (CMS) Lein Han, Ph.D. (CMS) Neil Gittings,M.A. (CMS) June 2004
Study Objectives • Describe rates of potentially preventable adverse events among hospitalized Medicare beneficiaries • Nationally • Within specific subgroups • Disaggregate selected complications • Explore internal validity • Targeting specific complications • Different ways of describing the relative importance of adverse events
Methods • Medicare hospital claims data: Fee-for-service beneficiaries 2000 and 2001 • Adapt AHRQ Patient Safety Indicators for Medicare beneficiaries • Review of PSIs by CMS Workgroup: Select 12 measures • Specify measures for disaggregation • Excess LOS, charges, mortality attributable to PSIs: Zhan et al. 2003 • Adapt to Medicare: convert to relative ratios
Relative Ratios for Excess LOS and Mortality Zhan et al. JAMA, 2003; 290: 1868-1874
Conclusions • Decubitus ulcers, postoperative septicemia, postoperative respiratory failure • Occur commonly • Affect large numbers of people • Disparities in rates of patient safety events by age, dual eligibility, black ethnicity, and ESRD
Conclusions (cont.) • Exploration by disaggregation and by DRGs: • Mixed support for internal validity • DRGs may provide another way to target efforts
Policy Implications • MQMS PSIs: inexpensive, powerful means of tracking safety for Medicare beneficiaries in FFS program • Results suggest focusing attention on: • Decubitus ulcers, postoperative septicemia, and postoperative respiratory failure • Elderly, dually eligible, black, and ESRD beneficiaries
Policy Implications (cont.) • Potential considerations for targeting interventions • Rates • Absolute numbers • Impacts on LOS, (charges), mortality • Importance of surgical infections--Postoperative Sepsis, and Selected Infections • CMS-QIO Surgical Infection Project