title: Episode-Based Approaches to Measuring Health Care Quality.
abstract: Most currently available quality measures reflect point-in-time provider tasks, providing a limited and fragmented assessment of care. The concept of episodes of care could be used to develop quality measurement approaches that reflect longer periods of care. With input from clinical experts, we constructed episode-of-care frameworks for six illustrative conditions and identified potential gaps and measure development priority areas. Episode-based measures could assess changes in health outcomes ("delta measures"), the amount of time during an episode in which a patient has suboptimal health status ("integral measures"), quality contingent upon events occurring previously ("contingent measures"), and composites of measures throughout the episode. This article identifies a number of challenges that will need to be addressed to advance operationalization of episode-based quality measurement.
authors.affiliation: 1 RAND Corporation, Boston, MA, USA.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Hussey
authors.affiliation: 1 RAND Corporation, Boston, MA, USA.|5 Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA.|6 Harvard Medical School, Boston, MA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Friedberg
authors.affiliation: 2 RAND Corporation, Arlington, VA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Anhang Price
authors.affiliation: 3 RAND Corporation, Pittsburgh, PA, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Lovejoy
authors.affiliation: 4 RAND Corporation, Santa Monica, CA, USA.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Damberg
mesh_terms: D017050:Episode of Care; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D019984:Quality Indicators, Health Care
keywords: episode of care; health care; outcome and process assessment (health care); quality indicators; reimbursement mechanisms