title: Correlations among measures of quality in HIV care in the United States: cross sectional study.
abstract: 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.
authors.affiliation: Department of Medicine, Institute for Clinical Research and Health Care Policy, Tufts-New England Medical Center, Boston, MA 02111, USA. iwilson@tufts-nemc.org
authors.forename: Ira B
authors.initials: IB
authors.lastname: Wilson
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Landon
authors.forename: Peter V
authors.initials: PV
authors.lastname: Marsden
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Hirschhorn
authors.forename: Keith
authors.initials: K
authors.lastname: McInnes
authors.forename: Lin
authors.initials: L
authors.lastname: Ding
authors.forename: Paul D
authors.initials: PD
authors.lastname: Cleary
mesh_terms: 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