Envisioning the national health care quality report

1 INTRODUCTION..............................................................................19 Origins of the National Health Care Quality Report, 20 The IOM Committee on the National Quality Report on Health Care Delivery, 20 Defining Health Care Quality, 22 Recent Initiatives on Health Care Quality and Quality Reporting, 22 Other National and International Initiatives on Health Care Quality Measurement, 24 National Initiatives, 24 State Initiatives, 26 International Initiatives, 27 Quality Measurement and Reporting in Other Sectors, 29 Objectives of the National Health Care Quality Report, 30 Organization of the IOM Report, 34 2 DEFINING THE CONTENTS OF THE DATA SET: THE NATIONAL HEALTH CARE QUALITY FRAMEWORK....40 Recommendation, 40 Importance of the Framework, 42 National Health Care Quality Framework, 42 Overview, 42 Components of Health Care Quality, 43 Consumer Perspectives on Health Care Needs, 55 Consumer Perspectives on Health Care Needs as Reflected in Care for Specific Health Conditions, 57 Using a Matrix to Portray the Framework, 60 Equity in Quality of Care as a Cross-Cutting Issue in the Framework, 62 What About Efficiency?, 64 Summary, 66 3 SELECTING MEASURES FOR THE NATIONAL HEALTH CARE QUALITY DATA SET ...................................................................... 76 Recommendations, 76 Examining Potential Measure Selection Criteria, 80 Criteria for Selecting Individual Measures for the National Health Care Quality Data Set, 80 Major Aspects to Consider, 80 Specific Aspects to Consider When Selecting Measures, 82 Evaluating Individual Measures According to the Criteria, 87 Evaluation Criteria for the National Health Care Quality Measure Set, 88 Balance, 88 Comprehensiveness, 88 Robustness, 89 Measure Selection Process, 90 Steps in the Process of Measure Selection, 90 Role of an Advisory Body, 92 Reviewing and Updating the Measure Set, 93 Measuring Health Care Quality Comprehensively, 93 Types of Measures, 94 Role of Summary Measures, 94 Measures of the Structure, Processes, and Outcomes of Health Care, 96 Summary, 98 4 DATA SOURCES FOR THE NATIONAL HEALTH CARE QUALITY REPORT ......................................................................... 103 Recommendations, 104 Data Source Selection Criteria, 106 Credibility and Validity of the Data, 107 National Scope and Potential to Provide State-Level Detail, 107 Availability and Consistency of the Data Over Time and Across Sources, 108 Timeliness of the Data, 108 Ability to Support Subgroup- and Condition-Specific Analyses, 109 Public Accessibility of the Data, 109 Potential Data Sources, 109 Public Data Sources, 110 Private Data Sources, 116 CONTENTS xvii Evaluating Data Sources for the National Health Care Quality Data Set in the Short Term, 118 Coverage of Health Care Quality Components, 124 Data Sources for the National Health Care Quality Report, 129 Data Sources in the Short Term, 129 Encouraging the Long-Term Development of Electronic Clinical Data Systems, 131 Increasing Access to the National Health Care Quality Data Set, 133 Summary, 133 5 DESIGNING THE NATIONAL HEALTH CARE QUALITY REPORT.............................................................................................139 Recommendation, 139 Audiences for the National Health Care Quality Report, 140 Report Guidelines, 141 Defining the Content of the Quality Report, 141 Presenting Information in the Quality Report, 143 Audience Testing the National Health Care Quality Report, 150 Audience Testing Before Report Releases, 150 Evaluative Testing of Report Releases, 151 Promoting the Quality Report, 152 Communication Channels, 152 Partnerships, 154 Evaluating the Promotion Plan, 154 Summary, 155 APPENDICES A Workshop: Envisioning a National Quality Report on Health Care, 159 B Designing a Comprehensive National Report on Effectiveness of Care: Measurement, Data Collection, and Reporting Strategies, 167 C Submissions in Response to the Committee’s Call for Measures from the Private Sector, 179 D Selected Approaches to Thinking About the National Health Care Quality Report, 189 E Quality Measure Selection Criteria, 212