Correlations among measures of quality in HIV care in the United States: cross sectional study.
OBJECTIVE
To determine whether a selected set of indicators can represent a single overall quality construct.


METHODS
Cross sectional study of data abstracted during an evaluation of an initiative to improve quality of care for people with HIV.


METHODS
69 sites in 30 states.


METHODS
Medical records of 9020 patients.


METHODS
Adjusted performance rates at site level for eight measures of quality of care specific to HIV and a site level summary performance score (the number of measures for which the site was in the top quarter of the distribution).


RESULTS
Of 28 site level correlations between measures, two were greater than 0.40, two were between 0.30 and 0.39, four were between 0.20 and 0.29, and the 20 remaining were all less than 0.20. One site was in the top quarter for seven measures, but no sites were in the top quarter for six or eight of the measures. Across the eight quality measures, sites were in the top quarter no more often than predicted by a chance (binomial) distribution.


CONCLUSIONS
The quality suggested by one measured indicator cannot necessarily be generalised to unmeasured indicators, even if this might be expected for clinical or other reasons.
Wilson
Ira B
IB
Department of Medicine, Institute for Clinical Research and Health Care Policy, Tufts-New England Medical Center, Boston, MA 02111, USA. iwilson@tufts-nemc.org
Landon
Bruce E
BE
Marsden
Peter V
PV
Hirschhorn
Lisa R
LR
McInnes
Keith
K
Ding
Lin
L
Cleary
Paul D
PD
D017088:AIDS-Related Opportunistic Infections / Q000517:prevention & control; D023241:Antiretroviral Therapy, Highly Active; D003695:Delivery of Health Care / Q000592:standards*; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D014376:Tuberculosis / Q000517:prevention & control; D014481:United States