"Influences on Healthcare Quality Outcomes" is an outstanding example of a paper on the health system. Quality is defined as the extent to which healthcare services increase the likelihood of desired health outcomes. Outcomes, on the other hand, are identified with death, disability, disease, dissatisfaction, delays, and dollars. Relating the two, outcomes are used to determine the quality of services provided to patients. Despite the importance of patient perception and the financial status of a healthcare organization, outcomes are more commonly measured clinically (Micheletti, Shlala and Goodall, 1998). INFLUENCES ON HEALTHCARE QUALITY OUTCOMES In the preliminary study by Cowing, Davino-Ramaya, Ramaya, and Szmerekovsky (2009), a new, comprehensive model correlating healthcare quality outcomes with the psychosocial components of both clinicians and patients, as well as the business management perspective of healthcare organizations have been proposed.
This is envisioned to provide organizations with better knowledge on the impact of various operational improvement strategies and to allow them to choose the strategies best suit their goals and resources. As a result, the model shows that clinical outcomes are not enough to comprehensively define healthcare performance.
It recognizes that subjective assessments such as patient satisfaction are also needed to accurately determine healthcare performance. In this case, the establishment of the clinician-patient relationship is of primary importance in building the patient's perception of quality and satisfaction of care. It is thus in the hands of healthcare organizations to create strategies to strengthen this relationship and to monitor patient satisfaction. With these findings, the researchers suggest that new healthcare quality outcome survey tools be made to take into account the effect of patient satisfaction and to provide accurate information with regards to healthcare performance.
CURRENT STATE OF OUTCOMES RESEARCH It is now clear that outcomes research such as the one above is important in accurately measuring performance and subsequently improving healthcare quality outcomes. These are interrelated as identifying indicators of quality and performance are the ultimate goals of outcomes research. The study of Perrin (2002) looked into the current situation of outcomes research and the strategies that can be implemented to improve it. Although many academicians have been involved in outcomes research, not a lot become successful, because current practice in the healthcare sector overlooks the fact that merely defining and measuring health outcomes does not connote successful outcome research.
A significant part of understanding outcomes and arriving at specific outcomes is in knowing how the independent variables, the healthcare organization, patients or clinicians, can produce these outcomes. It is thus important to come up with models and methods that can infer the relation of specific healthcare systems with healthcare quality outcomes. As such, outcomes research needs to be given resources that are sufficient to develop new methods and models of inference. The study further suggested that a randomized clinical trial (RCT) relating a specific intervention to a predetermined outcome is an example of good outcomes research because it can be designed to answer a cause-and-effect relation.
However, conducting RCT needs a significant resource investment, especially when doing it to answer questions about a system as complex as the healthcare system. A large data set is also needed to draw significant conclusions from the data. The data acquisition processes such as response rates and study duration should also be equally extensive. In conclusion, the limitations in resources are the main deterrents in preventing researchers in making sensible outcomes research that determine the effects of particular components of healthcare systems on outcome measures. INFORMATION FROM OUTCOME MEASUREMENT SYSTEMS Healthcare quality outcome measures become more powerful for healthcare organizations as patients are now more equipped in choosing their healthcare providers because of the vast amount of information about the healthcare quality outcomes of hospitals that they have access to. In an effort by Micheletti, Shlala and Goodall (1998) to provide ways for quality improvement professionals to better evaluate quality outcomes measurement systems and to stay ahead of the highly-critical managed care payers, it was found that more sophisticated risk- and severity-adjusted data instead of raw outcomes data should be used.
But before that, the performance outcome measurement system should be able to measure up-to-date not only clinical outcomes but patient satisfaction and financial health as well. This can be in the form of comparative outcomes data, which compares actual and expected outcomes. In addition, merging the clinical and financial outcomes information and selling it to potential patients is a good strategy in ensuring the best healthcare service while maintaining the organization’ s financial health.
Finally, the data should be more accessible, so that the clinicians’ and payers’ acceptance of the data is increased. Conclusively, a comprehensive, updated and manipulated outcome measure is better in allowing healthcare organizations in providing the payers its best image and competitive edge. CONCLUSION The three studies are unanimous in recognizing the importance of patient satisfaction and financial status in measuring the performance outcomes of healthcare organizations. Unfortunately, they recognize that the current methods of measuring healthcare quality outcomes need improvement, either by new models that correlate outcomes with its effectors, physicians, patients, and healthcare organization, as suggested by Cowing et al.
(2006) and Perrin (2002), or by a more comprehensive measurement system implemented by healthcare organizations. However, it was Perrin (2002) who explicitly disclosed that resources are needed to effectively measure performance outcomes. Identifying the cause-and-effect relationship between outcomes and effectors is central to the objectives of outcomes research. Based on these three studies, healthcare quality performance outcomes are the achieved clinical results, financial status and patient satisfaction established to be affected by patients, clinicians, and healthcare organizations.
Because of the complexity of the healthcare sector, measuring them need equally complex systems and serious investment. Despite its cost, studies on outcomes are important to gain an edge in a competitive industry by improving the cost-effectiveness of hospital services and improving image to potential patients.
Cowing, M., Davino-Ramaya, C. M., Ramaya, K., and Szmerekovsky, J. (2009). Health Care Delivery Performance: Service, Outcomes, and Resource Stewardship. The Permanente Journal, 13(4), 72-77
Micheletti, J. A., Shlala, T. J., and Goodall, C. R. (1998). Evaluating Performance Outcomes Measurement Systems: Concerns and Considerations. Journal for Healthcare Quality, 20(2), 6-13.
Perrin, E. B. (2002). Some Thoughts on Outcomes Research, Quality Improvement, and Performance Measurement. Medical Care, 40(6), III89-III91.