More quality measures versus measuring what matters: a call for balance and parsimony.
External groups requiring measures now include public and private payers, regulators, accreditors and others that certify performance levels for consumers, patients and payers. Although benefits have accrued from the growth in quality measurement, the recent explosion in the number of measures threatens to shift resources from improving quality to cover a plethora of quality-performance metrics that may have a limited impact on the things that patients and payers want and need (ie, better outcomes, better care, and lower per capita costs). Here we propose a policy that quality measurement should be: balanced to meet the need of end users to judge quality and cost performance and the need of providers to continuously improve the quality, outcomes and costs of their services; and parsimonious to measure quality, outcomes and costs with appropriate metrics that are selected based on end-user needs.
Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA. gregg.s.meyer@hitchcock.org
Gregg S
GS
Meyer
Eugene C
EC
Nelson
David B
DB
Pryor
Brent
B
James
Stephen J
SJ
Swensen
Gary S
GS
Kaplan
Jed I
JI
Weissberg
Maureen
M
Bisognano
Gary R
GR
Yates
Gordon C
GC
Hunt
D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006761:Hospitals / Q000592:standards; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control; D015279:Organizational Culture; D016134:Organizational Policy; D016730:Program Development; D011785:Quality Assurance, Health Care / Q000379:methods*; D058996:Quality Improvement / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000191:economics; D014481:United States