Envisioning the National Health Care Quality Report (2001) / Chapter Skim
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Appendix E: Quality Measure Selection Criteria
Appendix E: Quality Measure Selection Criteria
Pages 212-222
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DEPARTMENT OF HEALTH AND HUMAN SERVICES WORKING GROUP ON THE NATIONAL HEALTH CARE QUALITY REPORT The U.S. Department of Health and Human Services (DHHS)
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If the measure is a structural measure, the structural feature should be open to modification by the system, and there should be a strong link between the structure and desired outcomes. The measure's time period should capture the events that have impact on clinical outcomes and reflect the time horizon over which the health care system had control.
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DONABEDIAN'S QUALITY ASSESSMENT TRIAD OF STRUCTURE, PROCESS, AND OUTCOMES Inclusivity or definitional range · Technical versus interpersonal care · Medical versus psychosocial need · Diagnostic, therapeutic, preventive, anticipatory, and rehabilitative care · Individual, familial, or social responsibility · Cost containment versus quality enhancement · Parsimoniousness Scientific validity · Causal validity · Scientific currency Measurement reliability and validity · Explicitness, specification, objectiveness of the criteria · Specification of the referent and matching with the criteria · Verification - Of the diagnosis - Of clinical data 4. Relevance, pertinence
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NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) HEALTH PLAN EMPLOYER DATA AND INFORMATION SET Desirable attributes of HEDIS measures include the following:
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If the measure is a structural measure, the structural feature should be open to modification by the system, and there should be a strong link between the structure and desired outcomes. The measure's time period should capture the events that have impact on clinical outcomes and reflect the time horizon over which the health care system had control.
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The data required for the measure should be available to the health care system during the time allowed for data collection. The measure should not be susceptible to cultural or other barriers that might make data collection infeasible (e.g., inpatient or physician surveys, there may be cultural or personal barriers that lead to biased responses; these would have to be addressed)
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PRESIDENT'S ADVISORY COMMISSION ON CONSUMER PROTECTION AND QUALITY IN THE HEALTH CARE INDUSTRY Examples of criteria for evaluating individual measures include scientific soundness (i.e., reliable, valid, appropriately adjusted) , importance of the quality concern, relevance to various users, potential to foster improvements in health status or well-being, evidence basis, interpretability, "actionability" (i.e., degree to which steps can be taken to address the concern)
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Department of Health and Human Services was to recommend at least two poten
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SOURCE: Institute of Medicine, 1999. INDICATORS FOR MEASURING HEALTH PERFORMANCE IN THE PUBLIC SECTOR, NATIONAL RESEARCH COUNCIL The charge to the Panel on Performance Measures and Data for Public Health Performance Partnership Grants (PPGs)
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REFERENCES Advisory Commission on Consumer Protection and Quality in the Health Care Industry.
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National Research Council.
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