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Quality is an essential concept in healthcare practice. Farmer, Black, and Bonow (2013) argue that “quality healthcare is the ability to offer the right care for the right client and at the right time” (p. 349). Experts have been identifying new frameworks and strategies to measure quality in medical practice. When quality is measured in healthcare, it can become easier for practitioners and stakeholders to identify new processes that can maximize patient outcomes. The discussion will examine the challenges associated with the use of outcomes to assess quality. The use of Quality-Adjusted Life Years (QALY) to inform health policy will also be described.
Outcomes for Assessing Quality: Challenges
Healthcare professionals can use outcomes to measure or assess quality. The approach identifies how a specific patent realizes his or her health needs. However, the use of outcomes as a basis of assessing quality is characterized by various challenges. For example, the inferences from patients’ outcomes are usually hard to make (Farmer et al., 2013). An individual’s health status might differ significantly from that of another client (Das, Hammer, & Sanchez, 2012). Individuals’ risk factors to specific conditions might be ignored by this measure. Sample sizes are critical whenever using outcomes to assess quality.
Specific occurrences such as readmissions might indicate the presence of poor care delivery processes. These gaps explain why the process of structure-based approaches can be used to measure quality effectively (Calvo et al., 2013). Despite such challenges, the approach can be embraced because it also delivers a number of advantages that can be used to support the health needs of more citizens.
Quality-Adjusted Life Years (QALY)
The QALY (Quality-Adjusted Life Years) is a scientific measure of the issues surrounding a specific disease and its burden (Das et al., 2012). This generic measure focuses on the quantity and quality of people’s lives. Economists and policymakers can “use the tool to assess the value for money of medical interventions” (Calvo et al., 2013, p. 5272). Farmer et al. (2013) indicate that 1 QALY is usually equivalent to one year in perfect wellbeing or health. This powerful framework can therefore be used to inform health policy. This is the case because the tool presents adequate insights that can guide policymakers whenever making their decisions.
Policies focusing on specific interventions or ideas will benefit from the use of the QALY measurement tool. The tool can identify the potential benefits of specific programs or laws in terms of costs. The tool also focuses on specific aspects such as health quality, availability, and quantity. The use of the QALY framework will make it easier for policymakers to come up with ideas that have the potential to transform the health outcomes of many patents (Farmer et al., 2013). This is a clear indication that the QALY framework is appropriate for informing health policy. Consequently, more underserved populations will significantly benefit from the implemented health policies.
Should be QALY be a Requirement?
One of the biggest questions faced by health practitioners and agencies is whether Quality-Adjusted Life Years (QALY) should be a requirement whenever implementing costly healthcare programs. The QALY framework goes further to measure the quantity and quality of life. The cost-utility analytical tool can be used to examine the cost-per-QALY (Calvo et al., 2013). The method makes it easier for institutions to implement various healthcare interventions to identify and allocate resources. The “value for money of medical interventions can be calculated using the QALY tool” (Farmer et al., 2013, p. 350).
The aspects of this framework explain why it should become a requirement of new healthcare programs that might be costly to implement. When the QALY is used, the implementers will identify the required resources and examine the outcomes of the program. The calculations will be used to make the right decisions regarding the implementation of the program. Every program that is capable of delivering positive health outcomes will be supported using the framework (Farmer et al., 2013). The tool will also be used to avoid implementing specific programs that might not support the diverse needs of the targeted population.
Costly programs in the healthcare sector can benefit from the QALY tool. The pioneers of a given program will clearly understand the unique benefits of implementing it. The tool will measure the value of money and ensure appropriate decisions are made (Das et al., 2012). Interventions that might not result in quality health outcomes for the greatest number of patients will be abandoned. The use of the tool will support the outcomes-based quality assessment in healthcare.
Healthcare quality should be evaluated and measured frequently. More often than not, intervention programs are analyzed and monitored before they are implemented. When used adequately, the QALY can be an effective tool for assessing the appropriateness of costly programs. Similarly, the QALY framework can make it easier for policymakers in healthcare to come up with better laws that have the potential to support the needs of the greatest number of patients (Farmer et al., 2013). These practices will result in new programs and healthcare delivery models that focus on the changing needs of the targeted patients.
Calvo, M., Subirats, Cessaroni, L., Maroto, J., de Pablo, C., & Miralles, F. (2013). Automatic assessment of socioeconomic impact on cardiac rehabilitation. International Journal of Environmental Research and Public Health, 10(1), 5266-5283.
Das, J., Hammer, J., & Sanchez, C. (2012). The impact of recall periods on reported morbidity and health seeking behavior. Journal of Development Economics, 98(1), 76‐89.
Farmer, A., Black, B., & Bonow, R. (2013). Tension between quality measurement, public quality reporting, and pay for performance. Journal of the American Medical Association, 309(4), 349-350.