title: Standards for measures used for public reporting of efficiency in health care: a scientific statement from the American Heart Association Interdisciplinary Council on Quality of Care and Outcomes research and the American College of Cardiology Foundation.
abstract: The assessment of medical practice is evolving rapidly in the United States. An initial focus on structure and process performance measures assessing the quality of medical care is now being supplemented with efficiency measures to quantify the "value" of healthcare delivery. This statement, building on prior work that articulated standards for publicly reported outcomes measures, identifies preferred attributes for measures used to assess efficiency in the allocation of healthcare resources. The attributes identified in this document combined with the previously published standards are intended to serve as criteria for assessing the suitability of efficiency measures for public reporting. This statement identifies the following attributes to be considered for publicly reported efficiency measures: integration of the quality and cost; valid cost measurement and analysis; minimal incentive to provide poor quality care; and proper attribution of the measure. The attributes described in this statement are relevant to a wide range of efforts to profile the efficiency of various healthcare providers, including hospitals, healthcare systems, managed-care organizations, physicians, group practices, and others that deliver coordinated care.
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Keenan
authors.forename: John E
authors.initials: JE
authors.lastname: Brush
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Bufalino
authors.forename: Michael E
authors.initials: ME
authors.lastname: Chernew
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Epstein
authors.forename: Paul A
authors.initials: PA
authors.lastname: Heidenreich
authors.forename: Vivian
authors.initials: V
authors.lastname: Ho
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Masoudi
authors.forename: David B
authors.initials: DB
authors.lastname: Matchar
authors.forename: Sharon-Lise T
authors.initials: SL
authors.lastname: Normand
authors.forename: John S
authors.initials: JS
authors.lastname: Rumsfeld
authors.forename: Jeremiah D
authors.initials: JD
authors.lastname: Schuur
authors.forename: Sidney C
authors.initials: SC
authors.lastname: Smith
authors.forename: John A
authors.initials: JA
authors.lastname: Spertus
authors.forename: Mary Norine
authors.initials: MN
authors.lastname: Walsh
mesh_terms: D000572:American Heart Association; D002318:Cardiovascular Diseases; D017598:Efficiency, Organizational / Q000592:standards*; D006291:Health Policy; D006801:Humans; D019984:Quality Indicators, Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards*; D012955:Societies, Medical; D016896:Treatment Outcome; D014481:United States