Leapfrog tool ‘se­ri­ously flawed’

Modern Healthcare - - OPINIONS | EDITORIALS -

The Amer­i­can Hos­pi­tal As­so­ci­a­tion and its mem­bers are com­mit­ted to pro­vid­ing safe, high-qual­ity health­care. A ma­jor part of that ef­fort is to pro­vide re­li­able in­for­ma­tion to pa­tients and their fam­i­lies so that they can make the best de­ci­sions about their care.

How­ever, the Leapfrog Group’s new tool, as de­tailed in your ar­ti­cle “Leapfrog Group on­line tool helps pur­chasers cal­cu­late cost of hos­pi­tal er­rors” (ModernHealth­care.com, July 25), lacks the rigor needed to draw ac­cu­rate con­clu­sions about the safety and costs of hos­pi­tal care.

The tool seeks to iden­tify ad­di­tional costs at­trib­ut­able to hos­pi­tal er­rors and as­sumes hos­pi­tals with higher grades on the Leapfrog score­card have lower costs. Leapfrog pro­vides no ev­i­dence demon­strat­ing that a high Leapfrog grade is cor­re­lated to lower costs. More­over, the tool’s method­ol­ogy treats sev­eral very dif­fer­ent kinds of cost data—to­tal cost, charges in­curred and es­ti­mated ad­di­tional cost—as if each rep­re­sents ad­di­tional costs that are at­trib­ut­able to med­i­cal er­rors. Lastly, Leapfrog fails to rec­og­nize that pa­tients with mul­ti­ple med­i­cal con­di­tions are more likely to re­quire ad­di­tional treat­ments thereby reach­ing an in­cor­rect con­clu­sion about what makes car­ing for such in­di­vid­u­als more costly.

With­out ad­di­tional ref­er­ence points or val­i­da­tion, the method­ol­ogy of this new tool is se­ri­ously flawed and pro­vides un­re­li­able in­for­ma­tion for pur­chasers and pa­tients.

Nancy Foster

Vice pres­i­dent of qual­ity and pa­tient safety pol­icy

Amer­i­can Hos­pi­tal As­so­ci­a­tion

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