Developing a reliable, valid, and feasible plan for quality-of-care measurement for cancer: how should we measure?
BACKGROUND
Recent changes in the US health care delivery system have raised expectations that the medical marketplace will compete on quality and cost of care. This effort will require a systematic evaluation of the measurement of quality of care as it applies to cancer and other critical conditions.


OBJECTIVE
To articulate the components of the design of quality-of-care measurement systems that must be considered and optimally manipulated to generate feasible, reliable, and valid data pertinent to patients with cancer.


METHODS
A synthesis of information obtained from literature reviews and experience.


METHODS
Four key areas of design that influence quality-of-care measurement scores are discussed: case identification, data source, data-collection strategies, and the quality of the care-measurement model.


RESULTS
Challenges associated with these design and measurement strategies are defined and discussed.


CONCLUSIONS
Policy analyses vary as a function of measurement domains. The design of a quality-of-care measurement system should consider trade-offs between validity and burden by considering the intricate relations between domains of measurement.
Kahn
Katherine L
KL
RAND, Santa Monica, California 90406, USA. kkahn@rand.org
Malin
Jennifer L
JL
Adams
John
J
Ganz
Patricia A
PA
D003625:Data Collection; D005240:Feasibility Studies; D006801:Humans; D008485:Medical Audit; D009369:Neoplasms / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D015203:Reproducibility of Results; D012107:Research Design; D020379:Risk Adjustment; D014481:United States