Odds and ends . . .

The National Committee for Quality Assurance (NCQA) says it plans to focus the next HEDIS standards on AIDS, hypertension, and cancer. Applied research centers are already testing quality measures across multiple sites. ********** Presenters at the annual meeting of the American Society of Plastic and Reconstructive Surgeons last November reported that when hospitals use multifunctional wound care teams and standardized protocols to identify at-risk patients and provide aggressive interventions, fewer patients develop nosocomial ulcers, significantly decreasing health care costs and morbidity. ******** Managed care has spawned new types of liability arising from alleged denial of treatment, failure to tell patients about treatments, or failure to refer patients to specialists. Such claims are becoming more commonplace, according to Mike Folio, an attorney with Lewis, Friedberg, Glasser, Casey & Rollins in Charleston, WV, in the November 1996 issue of Managed Care. MCOs can limit their liability through competent utilization review and documentation of reasons requests for treatment were denied. *********** Mortality rates for coronary artery bypass surgery in New York are lower than in any other state and are at their lowest since the state began its report card five years ago. The chance of dying from a bypass procedure in New York has dropped by more than 40% in the last six years, to 2.58 per 100 patients in 1994 from 3.52 in 1989. The state health commissioner credits the report card system itself with the improvement. ******** Both the 105th Congress and individual states may be inclined to enact anti-managed-care legislation in 1997, predicts the director of legislative affairs for the Association of Managed Healthcare Organizations in Washington, DC. Top issues are lengths of stay, consumer disclosure, and quality. Providers may be a strong driving force behind state bills. ********** Physicians who effectively and honestly communicate mistakes to their patients may be able to significantly reduce the risk of litigation, a Loma Linda (CA) University Medical Center study found. For both moderate and severe mistakes, patients were significantly more likely to consider litigation if the physician did not disclose the error. [Arch Intern Med 1996; 156:2,565-2,569.] ******** The Joint Commission on Accreditation of Healthcare Organizations performance reports will soon be available to the public free of charge on the Internet. Thus, the practice of notifying individual accredited organizations of the names and addresses of those who access performance reports is no longer feasible, the organization says.