The Downside of Performance Measures

Thursday, December 28th, 2006
This post was written by Melanie Matthews

The thing about performance measures is there can be a lot of caveats to the type of care given and the result – many of which can’t be reflected in a report card on the quality of care given at a hospital or by a physician.

Take for instance C-section rates. While the aim in labor and delivery is to have a low C-section rate, C-section rates can be influenced by patient risk factors (e.g., multiple pregnancy, previous C-section, greater than 36 weeks gestation, medical risk including hypertension, diabetes, etc.). However, most times, the reported C-section rates are not adjusted to reflect these factors, according to an article on the Michigan Hospital Association web site.

A woman I know had her first child this week. Weighing in at 10 lb. 2 oz., this baby spent its first two days of life in the NICU for problems related to a vaginal birth — problems that would have been avoided had a C-section been performed. The baby is also now going to physical therapy to hopefully fix an injury to his arm related to his birth.

This birth’s impact on the C-section versus vaginal birth rates would make the hospital’s quality ratings appear high, but a C-section would, indeed, have provided better quality care than this vaginal delivery.

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