Evaluating the Quality of Healthcare Delivery

We will begin by briefly discussing key developments in the U.S. and elsewhere underlying changing

perspectives toward the way quality of care is defined and evaluated. We will then outline and discuss a basic conceptual framework for selecting measures for evaluating the quality of care by hospitals and physicians. This discussion will draw attention to key distinctions between process and outcome measures and their relative advantages and disadvantages for evaluating quality of care. This module will also include examples of quality measures that are currently in use.

We will discuss key challenges in making valid comparisons among healthcare providers in terms of their quality of care including case mix differences, small sample sizes and data integrity issues. We will discuss methods and techniques for addressing such challenges. We will show how these methods and techniques can be applied in practice to produce more useful quality of care evaluations.

We will cover consumer report cards and value-based purchasing programs, both of which constitute

important applications of the science of measuring and evaluating quality of care. Consumer report cards on quality of care frequently exist within publicly available websites. These websites provide consumers and other interested parties with quality-related information for comparing the performance of hospitals and physicians. Such resources and tools have been produced by government agencies, private health plans, and business organizations. We will look at several examples of these resources and tools and consider their value as well as their limitations.