Health Affairs: Registries promote better care, U.S. needs to get up to speed
As healthcare costs increase around the world, many countries are beginning to rely on disease registries, which can produce substantial savings. An international study of 13 registries in five countries (Australia, Denmark, Sweden, the U.K. and the U.S.) found that registries enable healthcare professionals to engage in continuous learning as well as identify and share best clinical practices.
Published as a web first article Dec. 7 on Health Affairs, Stefan Larson, senior partner and managing director in the Boston Consulting Group’s Stockholm office, and colleagues examined 13 registries that dealt with six medical conditions or procedures. In addition to analyzing both published and unpublished registry data, the authors interviewed 32 healthcare professionals to better understand how registries function and to identify ways they are able to influence clinical practice.
The authors found many examples where the use of the registry was associated with improvements in health outcomes. For example, Sweden began a registry for hip replacement surgery in 1979. Since then, Sweden has reduced its revision burden (the number of surgeries that have to be repeated as a share of total hip replacements in a given year) to 10 percent, saving some $14 million per year. The authors estimated that if the U.S. had in place a similar registry for hip-replacement surgery, it would avoid some $2 billion of an expected $24 billion in total costs for these surgeries in 2015.
“[Our data] suggests that by making outcome data transparent to both practitioners and the public, well-managed registries enable medical professionals to engage in continuous learning and to identify and share best clinical practices,” Larson and company wrote. “The apparent result: improved health outcomes, often at lower cost.”
In effect, the registries studied functioned as a valued community partner, according to the authors, who added they worked to engage physicians and other clinical staff in the shared task of improving the quality of care and served as a clearinghouse for the dissemination and sharing of best practices.
The authors acknowledged that because the study was not a randomized controlled study that they cannot conclusively demonstrate a causal connection between the existence of registries and improvement in health outcomes. “Finally, because of the difficulty of finding consistent cross-national data on outcomes and costs, our estimates of costs avoided should be applied only with caution.”
“The U.S. health payor system is complex and fragmented, with few common reporting standards and clinical outcome metrics across this system—even within the same specialty,” the authors discussed. “There is no national mechanism to compel providers to report outcomes to disease registries. Nor is there a unique patient identifier that would enable researchers to combine data across different disease states to examine the effect of complex comorbidities.”
Larson and colleagues called on the U.S. government to create the necessary regulations and seed funding. They suggested that insurance companies and drug and device manufacturers should help advance registries' development "because the high-quality data that registries produce would help them focus on genuine innovations to improve clinical outcomes and bend the healthcare cost curve."
Health registries can contribute to improving patient outcomes by engaging doctors and other clinical professionals in identifying, comparing and adopting best practices that can transform care and lower costs, the authors concluded.
Published as a web first article Dec. 7 on Health Affairs, Stefan Larson, senior partner and managing director in the Boston Consulting Group’s Stockholm office, and colleagues examined 13 registries that dealt with six medical conditions or procedures. In addition to analyzing both published and unpublished registry data, the authors interviewed 32 healthcare professionals to better understand how registries function and to identify ways they are able to influence clinical practice.
The authors found many examples where the use of the registry was associated with improvements in health outcomes. For example, Sweden began a registry for hip replacement surgery in 1979. Since then, Sweden has reduced its revision burden (the number of surgeries that have to be repeated as a share of total hip replacements in a given year) to 10 percent, saving some $14 million per year. The authors estimated that if the U.S. had in place a similar registry for hip-replacement surgery, it would avoid some $2 billion of an expected $24 billion in total costs for these surgeries in 2015.
“[Our data] suggests that by making outcome data transparent to both practitioners and the public, well-managed registries enable medical professionals to engage in continuous learning and to identify and share best clinical practices,” Larson and company wrote. “The apparent result: improved health outcomes, often at lower cost.”
In effect, the registries studied functioned as a valued community partner, according to the authors, who added they worked to engage physicians and other clinical staff in the shared task of improving the quality of care and served as a clearinghouse for the dissemination and sharing of best practices.
The authors acknowledged that because the study was not a randomized controlled study that they cannot conclusively demonstrate a causal connection between the existence of registries and improvement in health outcomes. “Finally, because of the difficulty of finding consistent cross-national data on outcomes and costs, our estimates of costs avoided should be applied only with caution.”
“The U.S. health payor system is complex and fragmented, with few common reporting standards and clinical outcome metrics across this system—even within the same specialty,” the authors discussed. “There is no national mechanism to compel providers to report outcomes to disease registries. Nor is there a unique patient identifier that would enable researchers to combine data across different disease states to examine the effect of complex comorbidities.”
Larson and colleagues called on the U.S. government to create the necessary regulations and seed funding. They suggested that insurance companies and drug and device manufacturers should help advance registries' development "because the high-quality data that registries produce would help them focus on genuine innovations to improve clinical outcomes and bend the healthcare cost curve."
Health registries can contribute to improving patient outcomes by engaging doctors and other clinical professionals in identifying, comparing and adopting best practices that can transform care and lower costs, the authors concluded.