The state of Oregon is trying to figure out how well its healthcare reform efforts are doing. It’s going to an objective standard and looking at raw numbers. Namely, the state government is looking to deliver high-quality care, improve outcomes and save money, what Oregon Governor John Kitzhaber calls the “triple aim.”
The Oregon Health Authority has decided to track 17 issues. These include how many patients are readmitted to the hospital after being released, the rate of diseases such as diabetes and the number of unnecessary tests.
Another measurement is how many healthcare provider combine services, such as medical, dental and mental health facilities.
“So that patients don't have to go to three different buildings or three different sites to get care,” Lori Coyner of the Oregon Health Authority told Oregon Public Broadcasting. “But to pull it all together so that a patient for example, that has depression, can meet with a counselor right in the doctor's office.”
Another factor is how many patients abuse alcohol or other drugs.
“So there are a couple of ways a practice could do this,” Sarah Bartelmann, a metric coordinator for the Oregon Health Authority, said. “They could start with a pre-screen, that would be just one question that a doctor would ask. It could be part of your vital stat., when they're taking your blood pressure, weighing you in. They could also ask, ‘Do you use alcohol, do you use drugs?’ and that would be yes or no. And if the patient indicated that they did, to either one of those, that would then trigger a longer screening. That's what we're looking for."
Providers might be reluctant to ask patients questions like these. A patient who admits to substance abuse might warrant treatment, which costs the provider money. A study by the Oregon Health Sciences University (OHSU) found that 44 percent of doctors did ask about their substance abuse, so 44 percent was set as a baseline.
Another major goal is reducing readmissions, especially “all-cause” readmissions for Medicare and Medicaid patients, where they have to be treated for all ailments instead of the one that they initially came to the hospital for. Currently, the state is tracking readmissions within 30 days of being released from the hospital.
