Irrespective of their health conditions, all patients require timely, effective, and quality health care services. Overall, achieving the desired state of health care quality remains a leading goal of health care organizations. Processes, procedures, and routine interactions should ensure that patients are excellently served. Satisfaction should be a guiding principle. In health practice, quality of care represents the degree to which health services meet the desired outcomes. To examine whether they are providing quality care, organizations should regularly evaluate their performance using rate-based quality measures. Evaluating performance guided by rate-based quality measures is a practical way of improving care delivery and patient outcomes. This paper describes rate-based measures of quality in health care organizations. It further deconstructs each measure, describes the importance, and explains how each measure relates to patient safety and the cost of healthcare delivery.
Rate-Based Measures: Description
Quality measures are reliable indicators of a healthcare organization’s capacity to deliver optimal care. Rates show the difference between performance and expectations. Appropriate rate-based quality measures for in-depth exploration include readmission rates, complication rates, and post-procedure death rates. These measures have been selected since they directly relate to the type of care that patients receive in health care settings. Their rates are inversely proportional to the quality of care. For instance, high readmission rates indicate that the quality of care does not meet the desired performance levels. The same case applies to complication rates and post-procedure death rates.
The other reason for selecting these measures is their significance in the overall health care provision in the United States. The Centers for Medicare & Medicaid Services (CMS) reports that quality health care is a priority for the President of the United States, Department of Health and Human Services, and CMS (Centers for Medicare & Medicaid, 2020). Due to the significance and interest of quality health care, CMS uses quality initiatives for health improvement in many instances and spends considerable resources in quality enhancement programs. As a result, the rate-based quality measures indicate the extent to which health care organizations align with the President’s and CMS’ expectations as far as quality is concerned.
Health care organizations require tools for quantifying healthcare processes. The selected rate-based measures are used for quantifying outcomes. Quantifying the processes and outcomes shows an organization’s ability to provide high-quality care. Quantifying outcomes by rating them also indicates the areas requiring more attention as the organization adopts new quality improvement mechanisms.
Deconstructing Each Measure
When a patient visits a healthcare organization for medical assistance, the general desire is to get an accurate diagnosis and proper treatment. Such assistance promotes healing and helps the patient to recover within the healthcare facility or at home. Unfortunately, health complications may necessitate readmission. Upadhyay et al. (2019) described readmission rate as hospital admission occurring within a specified time frame after discharge from the first admission. As a result, the readmission rate denotes the percentage of patients readmitted after discharge. Readmission rates may be calculated in terms of weeks, months, or annual readmission.
With hospital-acquired infections (HAIs) a sincere concern in health care delivery, the complication rate should guide health care providers in preventing HAIs. Lim (2019) described the complication rate as the percentage of patients developing complications resulting from care. In most instances, complication rates are high in complex procedures such as surgeries. For instance, the complication rate associated with heart surgeries is often higher than treatment for malaria. Routinely, many health care organizations track the complication rate by a specific timeframe or division. In this case, all complications can be calculated together or segmented according to the type of disease. The extent of complication rate indicates the quality of care that patients receive in a particular health care setting.
After the treatment, patients always look forward to a full and speedy recovery. Healthcare organizations also implement the necessary measures to prevent deaths to ensure that the mortality rates for all illnesses are as low as possible. Despite these efforts, deaths still occur after procedures. According to Lim (2019), the post-procedure death rate is the number of deaths occurring after treatment. The death rate usually varies depending on the procedure. Like readmissions and complication
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