“We are about to embark on a huge transformation of our health care system,” Dr. Bach said. “If we start with a bunch of flawed measures, it will be as devastating as putting in the wrong coordinates before a moon shot.”
Dr. Elliott S. Fisher, director of the Center for Health Policy Research at the Dartmouth Institute, said the larger issue was that just because a hospital charges a lot does not mean that it delivers good care. But Dr. Fisher agreed that the current Atlas measures should not be use to set hospital payment rates, and that looking at the care of patients at the end of life provides only limited insight into the quality of care provided to those patients. He said he and his colleagues should not be held responsible for the misinterpretation of their data.
For quite a while now, it had been *widely accepted* that the Dartmouth Atlas analysis should be utilized as the guiding or organizing principle for health care reform. Atul Gawande’s New Yorker article also utilized the D.A as the basis for many of his arguments.
IN the last issue of the NEJM, Peter Bach issues a strong statement that the Dartmouth Atlas should not be used to determine payment formulas to hospital and physicians, nor form the cornerstone of reform.
Perhaps more interesting, Dr Elliot Fischer, the Director of Health Policy Research at Dartmouth states that “…he and his colleagues should not be held responsible for the misinterpretation of their data.”
REALLY ??? In the end, even Dr Fischer agrees that his institutions data should not be utilized as the basis for payment reform.
No wonder there is so much confusion about health care reform… some of its core or guiding principles make sense… but the data that the administration is using to formulate the particulars is flawed… and as Dr Bach concludes… “If we start with a bunch of flawed measures, it will be as devastating as putting in the wrong coordinates before a moon shot.”