More Evidence That the Healthcare Administrative Burden Is Real, Widespread and Has Serious Consequences; Comment on “Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study”

Document Type : Commentary

Author

Department of Interdisciplinary Studies, Rutgers University, Newark, NJ, USA

Abstract

Countries around the world have implemented programs to help monitor and enhance the quality of health services provided. Inherent in these programs and internal process improvement initiatives are an array of reporting requirements which often place a burden on clinicians and the organizations in which they function. Zegers and colleagues performed a mixed methods study on the perceived burden which these reporting requirements place on doctors, nurses, and other clinicians within three hospitals in the Netherlands. Like all studies, theirs has some minor limitations; most notably possible limits on generalizability from a limited sample. Nonetheless, their project makes a valuable contribution to the growing body of research which suggests that the burden has deleterious effects on clinicians and may well have an erosive impact on patient care.

Keywords


  1. Zegers M, Veenstra GL, Gerritsen G, Verhage R, van der Hoeven HJG, Welker GA. Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study. Int J Health Policy Manag. 2020;10.34172/ijhpm.2020.96. doi:34172/ijhpm.2020.96
  2. Heuer AJ, Parrott JS, Percival D, Kacmarek RM. Examining the phenomenon of the administrative burden in health care, allied health, and respiratory care. J Allied Health. 2016;45(2):152-156.
  3. Porter ME. A strategy for health care reform--toward a value-based system. N Engl J Med. 2009;361(2):109-112. doi:1056/NEJMp0904131
  4. Van Loon NM. From red tape to which performance results? exploring the relationship between red tape and various dimensions of performance in healthcare work units. Public Adm. 2017;95(1):60-77. doi:1111/padm.12294
  5. Lorkowski J, Maciejowska-Wilcock I, Pokorski M. Overload of medical documentation: a disincentive for healthcare professionals. Adv Exp Med Biol. 2021;1324:1-10. doi:1007/5584_2020_587
  6. Rao SK, Kimball AB, Lehrhoff SR, et al. The impact of administrative burden on academic physicians: results of a hospital-wide physician survey. Acad Med. 2017;92(2):237-243. doi:1097/acm.0000000000001461
  7. Fung CH, Lim YW, Mattke S, Damberg C, Shekelle PG. Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med. 2008;148(2):111-123. doi:7326/0003-4819-148-2-200801150-00006
  8. Saver BG, Martin SA, Adler RN, et al. Care that matters: quality measurement and health care. PLoS Med. 2015;12(11):e1001902. doi:1371/journal.pmed.1001902
  9. Shaw J, Taylor R, Dix K. Uses and Abuses of Performance Data in Healthcare. London: Dr Foster. 2015;40.
  10. Schäfer W, Kroneman M, Boerma W, et al. The Netherlands: health system review. Health Syst Transit. 2010;12(1):v-xxvii, 1-228.
  11. Bal R, de Bovenkamp HV, Wallenburg I. [Regulation and safety in healthcare: response to the report by the Netherlands Centre for Ethics and Health]. Ned Tijdschr Geneeskd. 2019;163. [Dutch].
  12. Casalino LP, Nicholson S, Gans DN, et al. What does it cost physician practices to interact with health insurance plans? Health Aff (Millwood). 2009;28(4):w533-543. doi:1377/hlthaff.28.4.w533
  13. de Vos M, Graafmans W, Kooistra M, Meijboom B, Van Der Voort P, Westert G. Using quality indicators to improve hospital care: a review of the literature. Int J Qual Health Care. 2009;21(2):119-129. doi:1093/intqhc/mzn059
  14. Burstin H, Leatherman S, Goldmann D. The evolution of healthcare quality measurement in the United States. J Intern Med. 2016;279(2):154-159. doi:1111/joim.12471
  15. Andersen LB, Kristensen N, Pedersen LH. Documentation requirements, intrinsic motivation, and worker absence. Int Public Manag J. 2015;18(4):483-513. doi:1080/10967494.2015.1028582
  16. Botje D, Ten Asbroek G, Plochg T, et al. Are performance indicators used for hospital quality management: a qualitative interview study amongst health professionals and quality managers in the Netherlands. BMC Health Serv Res. 2016;16(1):574. doi:1186/s12913-016-1826-3

Articles in Press, Corrected Proof
Available Online from 08 September 2021
  • Receive Date: 10 May 2021
  • Revise Date: 02 September 2021
  • Accept Date: 06 September 2021