Dallas business and healthcare officials this year will embark on an ambitious project to measure the value and quality of an entire episode of medical care from pregnancy through birth.
Although business coalitions in other cities have contracted with vendors to gather quality information on hospitals, Dallas' Health Care Value Initiative is believed to be the first to combine hospital, physician and patient satisfaction data.
"What sets this project apart from other coalition-led initiatives around the country is that we will be measuring value across the continuum of care," said Marianne Fazen, executive director of the DFW Business Group on Health.
The effort marks a rebirth for the group, which previously focused on educational programs for employee benefit managers. Then last year, the employer group decided to take an approach that would help members measure and improve healthcare values in the Dallas-Fort Worth area.
The DFW Business Group has 173 members, including such major employers as American Airlines, EDS and Texas Instruments. Its member companies represent 250,000 workers plus another 300,000 dependents and spend $800 million annually on healthcare.
A survey of the coalition's members found that their top healthcare concern was pregnancy and childbirth. That Quality
was followed by cardiovascular illnesses, orthopedics, mental health/substance abuse and cancer.
The group's efforts to measure quality will begin with obstetric care, then follow with similar analyses of the other specialties, Fazen said. "We want to know where are the best doctors and the best hospitals," Fazen told providers in announcing the effort last month.
The coalition invited the Dallas-Fort Worth Hospital Council and the Dallas County Medical Society to collaborate on the project. A team of obstetricians, neonatologists and quality-assurance professionals worked last year to define value indicators. Criteria on the hospital side include Caesarean section rates, readmission and complication rates, prematurity, low birth weight and length of stay.
The initiative will be underwritten by each of three groups involved. Hospitals will pay for the analysis and gathering of the hospital data, physicians will pay for office visit data analysis, and employers will pay for the health risk assessment and patient satisfaction surveys.
Each group is selecting its own vendor. So far, the only vendor selected has been HCIA, a Baltimore-based healthcare information firm that will collect and analyze the hospital data.
Although the initiative is voluntary, nearly all the area's 65 hospitals are expected to participate, said John Gavras, president of the hospital council. Gavras said the data analysis is expected to cost each hospital between $3,000 and $5,000 for each specialty. The cost will vary depending on how many hospitals participate. For example, about 35 hospitals offer obstetrics. So the cost may be higher for that data analysis than cardiology, which is provided by more area hospitals.
The group plans to report results to employers this year and the public in 1997.