Criteria for evaluating healthcare quality need to be refined

The Society takes the view that good management of health care units, health system building and continuous quality improvement require the introduction of indicators to support these processes, and recognizes the need for uniform quality criteria.

However, the regulation of quality indicators, itself should be "high quality," allowing comparisons of treatment results and patient conditions in different health care entities.

PTLM points out that quality indicators must be precise, unambiguous and tailored to the specifics of different types of health care units, such as district hospitals, teaching hospitals and specialized hospitals. One of the key demands is that the indicators allow a fair comparison of the results of treatment and the conditions of patients in different facilities. The current draft regulation raises concerns about the ability to fairly compare units, as the proposed criteria are uneven and may be interpreted differently by experts.

Particularly critical were clinical indicators that do not take into account the specific patient populations treated by each unit. PTLM notes that hospitals caring for elderly patients or those with multimorbidity may be rated worse than those treating younger and less burdened patients. Therefore, these indicators can only be used for internal analysis of a unit over the years, but should not be used to compare different facilities.

The Society draws attention to the lack of indicators assessing the cooperation and integration of health care units, both horizontally and vertically, with other facilities, such as family doctors and specialized outpatient clinics. The current draft treats hospitals as isolated units, which PTLM believes is the wrong approach.

In the consumer area, PTLM expressed its concern about the lack of clear evaluation criteria and a precise way to measure them. The Society proposes the introduction of "patient experience" indicators that would allow a more objective assessment of healthcare quality from the patients' perspective.

Management indicators also need clarification. PTLM stresses that it is unclear how individual indicators are supposed to affect the quality of care, and what specific outcomes are supposed to guarantee the desired quality. An example is the criterion of the number of consultations per physician in outpatient specialty care, which can be interpreted differently as to the preferred number of visits per hour.

The Polish Society of Physician Managers also calls for the introduction of indicators to assess working conditions in health care units, such as the provision of postgraduate education, the number of occupied accredited places for specialization, the number of doctors and nurses who resigned in the past year, and the number of medical caregivers per number of patients. PTLM believes that these parameters can significantly affect the quality of the teams' work and thus the results of treatment.

The Polish Society of Medical Managers is calling for the development of criteria for evaluating the quality of health care that are reliable, non-controversial, comprehensive and focused on actual medical outcomes. The Society stresses that well-constructed quality indicators can help improve quality management in health care in Poland.

Source: PTLM