Overview

In this course, you will have the opportunity to learn about the great progress that has been made in measuring and evaluating quality of care. We will discuss key concepts and methods. You will also learn about how to use websites for comparing the quality of healthcare providers. The course content is intended for a wide range of participants – for example, people who have a general interest in quality of care, consumers seeking information about how to choose a provider for themselves or family members, or leaders of business organizations who are responsible for employee health insurance benefits and network of providers. By the end of this course, the learner should be able to: 1. Explain key developments regarding how quality of care is measured and evaluated in the US. 2. Articulate basic framework for evaluating quality of outcomes of care including types of and criteria for selecting quality measures for evaluating and comparing providers. 3. Discuss scientific issues and challenges for evaluating quality of care and methods for addressing these challenges. 4. Identify and apply resources and tools for comparing the quality of care of providers.

Syllabus

Foundational Concepts for Evaluating Quality

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.

Scientific Issues and Challenges for Comparing Quality of Care Among Providers

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.

Resources and Tools for Evaluating Quality

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.

Future Directions in Evaluating Quality of Care

We will discuss emerging developments pertaining to the science and practice of evaluating quality of care. This discussion will include the increased interest in value-oriented measures of provider performance (i.e., efficiency as well as quality) and in composite measures. Also, we will consider the debate over whether quality measures should be adjusted to account for differences among providers regarding the socio-economic characteristics of their patients and how such adjustments could be conducted.