2023-11-07 18:05:35
An analysis by the consulting firm Iqvia of more than 500 private health centers makes the care data of the private sector transparent. “Because, if something is not measured, it does not improve,” says Juan Abarca, president of IDIS.
The data from the RESA 2023 Study of health outcome indicators in private healthcare were presented this morning. Juan Abarca, president of the IDIS foundation, has detailed that, after a few years marked by the Covid-19 pandemic, the report has been resumed in its ninth edition. “It’s a transparency exercise of private sector hospitals that has not been able to be done since 2019, because the data was skewed by the pandemic. The results allow us to improve processes and generate competitiveness. Because, if something is not measured, it does not improve” he highlighted.
The RESA study has been detailed by Martha Villanuevageneral director of the IDIS Foundation and Nicolas Guerra, general director of IMQ clinics. The work has counted, in this year’s edition, with more than 500 participants and more than 100 indicators -30 of them new- that have evaluated 130 private hospitals, 120 outpatient centers and 311 assisted reproduction centers. Carried out by the consulting firm IQVIA, in total data has been collected from more than 700,000 hospital discharges analyzed, some five million visits to the emergency room collected, almost five million visits to outpatient clinics and some 100,000 fertility cycles have been analyzed. All the data can be consulted on the website of the IDIS foundation.
“The Private healthcare has been able to adapt and respond to the needswith a very representative sample, with an exponential growth of centers and indicators since we began to prepare these reports in 2012. We promote continuous improvement, transparency and competitiveness between centers, because we must continue improving,” Villanueva summarized.
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Editor: MARÍA ALBALAT BELLO
The first point of contact between a patient and their healthcare is the accessibility that the patient has with the healthcare system: private healthcare continues to show a downward trend with respect to the previous RESA study in average waiting times for the appointment for radiodiagnostic tests (mammography, CT and MRI) and the delivery of these same reports. “These declines are due to innovation,” said Villanueva.
A similar downward trend is observed with respect to the average waiting times for appointments for laboratory tests (biochemistry and hematology or microbiology, genetics and immunology), being less than one day in any case. Also The same thing happens with the average waiting times for the delivery of laboratory reports.which show that their results are received as soon as the laboratory results are known: on the same day in the case of biochemistry, and in less than two days in microbiology, immunology and genetics.
Average waiting times for appointments in outpatient clinics have increased in all specialties, as well as the average surgical wait. This, according to those responsible for the study, is probably a reflection of the saturation of these specialty consultations and elective surgeries in the National Health System after the impact of the COVID-19 pandemic.
The results also show that accessibility to emergency care improves both in the average time between admission to the emergency room and triage, and in the average time between triage and healthcare. Another notable fact is that the refined average stay is 2.9 days on average (compared to 3.57 in 2019), with the Oncology service being the one with the highest average consumption of stays.
On the other hand, the average preoperative stay shows that, in scheduled episodes, patients barely show preoperative admission (0.3 days). While, in urgent episodes, they show average pre-surgical stays of 1.7 days on average.
Finally, although the COVID-19 pandemic has possibly caused greater complexity for some of the patients operated on in 2022 given the delay in their surgeries, the outpatient rate for surgical procedures was approximately 45%.
Assistance resolution
Solo 4.5% of patients discharged from hospitalization had to be readmitted in the subsequent 30 days (4.9% in the previous report). If the initial admission was for a surgical reason, only 1.2% of patients required readmission in the following seven days. If it was an outpatient surgery, this 30-day readmission rate drops to 0.5%, compared to 0.7% in 2019.
This capacity for care resolution is also observed in the management of the Emergency Department, with a return rate to the Emergency Department after 72 hours of 3.1%, a value even lower than the 2019 edition, which was 3.7%.
Patient safety
“The results of the study show the low prevalence of complications and associated mortality in private healthcare: the vast majority of indicators analyzed show complication rates very close to 0%, such as the mortality rate in low-mortality DRG (0.12%) or the rate of blood infection related to central venous catheter (0.02%) , measured with the indicators of the Agency of Healthcare Research and Quality (AHRQ)”, highlighted Nicolás Guerra.
The complication rate obtained with the highest result was obstetric trauma in vaginal delivery, with an incidence of 2.9%.
Specific indicators
The other great novelty of this RESA 2023 study is the analysis of specific indicators in eight clinical processes: acute myocardial infarction, childbirth, surgical biliary pathology, hip fracture, breast, lung, prostate and cataract cancer.
In the results of the process hip fracture, Patients remain hospitalized for an average of 7.9 days. 5.2% of patients have a stay of more than 20 days. In addition, more than 65% of patients undergo surgery in less than 48 hours from admission, compared to 85% in 2019.
Regarding the results of the birth process, The average stay is less than three days, with a slight increase in the rate of cesarean deliveries (34.7%) compared to the previous RESA study. Less than 6% of women are admitted to the hospital with false labor. And, despite the complexity of vaginal births after a previous cesarean section, more than 30% of patients carry them out in private healthcare.
As for the oncological clinical processes, The results demonstrate the capacity of private healthcare to manage highly complex processes such as breast cancer and prostate cancer, showing stays of less than two and 3.5 days respectively. The mortality rate is approximately 1.5% in both tumor types and readmission rates are less than 2.2% and 4.9%, respectively.
He lung cancer It is a tumor that tends to be diagnosed in advanced stages, which further increases the complexity of these patients. In this case, they remain hospitalized for an average of 6.4 days and a readmission rate of less than 18% is observed.
Lastly, the in-hospital mortality rate was 13.1% on average, although there is variability of up to 25%, possibly due to differences in the case mix of patients treated.
With respect to acute myocardial infarctionGuerra has stressed that the results show good management in private healthcare of complex – and also very urgent – episodes such as heart attacks. Patients remain hospitalized for an average of five days, with less than 8% requiring readmission in the subsequent 30 days and with an in-hospital mortality rate of approximately 5%.
The data of the bile duct disorders such as cholelithiasis or cholecystitis treated by surgical procedures suggest a high level of efficiency and resolution of care, with an average stay of less than two days (1.4) and a readmission rate of only 2.1%.
Finally, the RESA study returns to include an analysis of readmissions due to complications after cataract surgeryand shows a rate even lower than that of the previous report (0.1%).
Fertility center data
Las figures collected in 311 assisted reproduction centers show a very clear pattern in the results: both in the case of own oocytes and in that of donated oocytes, there is a slight downward trend in the rate of pregnancies and births with fresh oocytes. And an increasing trend in the rate of pregnancies and births with frozen oocytes.
In the care of patients on hemodialysis, minor changes are observed with respect to the results of the previous year, with a mortality rate of less than 10% and a percentage of patients with Kt/V or with objective albumin levels much higher than the standard values recommended by the Spanish Society of Nephrology.
“We can be ssatisfied with the resultsbecause the indicators have improved in a complicated context, with reinvention processes, betting on innovation providing answers and security,” Villanueva stressed.
For Nicolás Guerra, progress must be made in health indicators “so that citizens have consistent information when seeking health care.” Another challenge that he has considered key is incorporating efficiency into monetary results.
170 entities, recognized
Furthermore, after the presentation of the report data, the ceremony took place that awarded the institutions with the QH Recognition of the IDIS Foundation. 170 public and private assistance organizations already have it, with 13 new stamps being delivered today, 71 for renewal and 11 category upgrades, in the tenth call.
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