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Tuesday, January 19, 2010
How will we know?
Jo Porter
New Hampshire Institute for Health Policy and Practice
In the current health reform climate, there is a tremendous amount of disagreement. Different political parties disagree about how close we are to a solution to the health care problem, members within individual parties disagree with one another, communities disagree with one another…it is a decisive issue. Yet, there are a couple of things that people do seem to agree on: 1) We have a problem that needs to be fixed and 2) we have to be able to measure our progress.
While there is agreement that we need to measure our progress, there is no clear indication of how we will do that. One issue, of course, is that data are so, um, modifiable in interpretation. The exact same statistic can be used by different people with different interpretations. And the data are imperfect. Does that mean that we should discount the need to measure progress? No.
We have to understand the limitations of what we have, accept those limitations, and be cognizant of those limitations when we interpret our analyses. This does not mean, though, that we cannot understand our progress. We can measure our success (or failure), and we can learn lessons, make changes, and measure again. The data are here. And we keep getting better at collecting and using it.
How might we know if we are successful in health care reform? We will measure how many people report having health insurance coverage (through, for example, the NH Behavioral Risk Factor Surveillance System). We will know how many people are going to the ER for conditions that can usually be managed in primary care offices, and hope that those numbers go down (through, for example, the NH Hospital Discharge Data). We will know how many people die from conditions that are treatable (through, for example, the NH death data). We will know how many women who have babies received adequate prenatal care (through, for example, the NH birth data).
Interestingly, I suspect that the same data will be used by different parties to say different things. And what does that mean for us? In my opinion, that means that we have to be savvy about our own interpretations. It means that before believing or discounting information as good or bad, we need to ask ourselves what the data really tell us, what the limitations to our conclusions are, what the best interpretation of the data is, and what that interpretation means to us. We cannot believe everything we hear; but, we can listen, think, and interpret for ourselves. Interestingly, for people like me (self-proclaimed data geek), that’s the fun part.
Tags: Citizens Health Initiative, health data, Health Reform, Institute for Health Policy and Practice, measuring progress, NH Behavioral Risk Factor Surveillance System, NH birth data, Polital parties