Care that Matters: Quality Measurement and Health Care

PLoS Medicine

Volumn 12, Issue 11, 2015, Pages

  Saver, Barry G ^a,b   Martin, Stephen A ^a   Adler, Ronald N ^a   Candib, Lucy M ^a   Deligiannidis, Konstantinos E ^a   Golding, Jeremy ^a   Mullin, Daniel J ^a   Roberts, Michele ^c   Topolski, Stefan ^a  

^a UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL   (United States)

^b Swedish/Cherry Hill Family Medicine Residency Faculty   (United States)

^c Freelance Science Writer   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CLINICAL TRIAL (TOPIC); COST EFFECTIVENESS ANALYSIS; GOVERNMENT REGULATION; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; HEALTH INSURANCE; HUMAN; MEDICATION THERAPY MANAGEMENT; OUTCOME ASSESSMENT; PRIVATE HEALTH INSURANCE; QUALITY CONTROL; UNNECESSARY PROCEDURE; EVIDENCE BASED PRACTICE; PATIENT CARE; PATIENT PREFERENCE; PATIENT SATISFACTION; TREATMENT OUTCOME;

EVIDENCE-BASED PRACTICE; HUMANS; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE); PATIENT PREFERENCE; PATIENT SATISFACTION; PATIENT-CENTERED CARE; QUALITY ASSURANCE, HEALTH CARE; QUALITY INDICATORS, HEALTH CARE;

EID: 84949441210     PISSN: 15491277     EISSN: 15491676     Source Type: Journal    
DOI: 10.1371/journal.pmed.1001902     Document Type: Article

References (58)

1. Donabedian A, Evaluating the quality of medical care. Milbank Mem Fund Q. 1966/07/01 ed. 1966;44: Suppl:166–206.
2. Woolf SH, Aron LY, The US health disadvantage relative to other high-income countries: findings from a National Research Council/Institute of Medicine report. Jama. 2013/01/12 ed. 2013;309: 771–772. doi: 10.1001/jama.2013.91 23307023
3. Lindenauer PK, Lagu T, Ross JS, Pekow PS, Shatz A, Hannon N, et al. Attitudes of hospital leaders toward publicly reported measures of health care quality. JAMA Intern Med. American Medical Association; 2014;174: 1904–11.
4. American Association of Medical Colleges. Guiding Principles for Public Reporting of Provider Performance. 2014 [cited 2 Apr 2015]. http://perma.cc/27BL-G6TY
5. Burwell SM, Setting Value-Based Payment Goals—HHS Efforts to Improve U.S. Health Care. N Engl J Med. 2015;372: 897–9. doi: 10.1056/NEJMp1500445 25622024
6. Better, Smarter, Healthier: In historic announcement, HHS sets clear goals and timeline for shifting Medicare reimbursements from volume to value. U.S. Department of Health and Human Services; 2015 [cited 2 Apr 2015]. http://www.hhs.gov/news/press/2015pres/01/20150126a.html
7. Medicare Payment Advisory Commission. CMS List of Measures under Consideration for December 1, 2014. 2015. http://perma.cc/FY9C-RJPU
8. Glasziou PP, Buchan H, Del Mar C, Doust J, Harris M, Knight R, et al. When financial incentives do more good than harm: a checklist. Bmj. 2012/08/16 ed. 2012;345: e5047–e5047. doi: 10.1136/bmj.e5047 22893568
9. Micheel C, Ball J, Institute of Medicine (U.S.). Committee on Qualification of Biomarkers and Surrogate Endpoints in Chronic DiseaseEvaluation of biomarkers and surrogate endpoints in chronic disease. Washington, D.C.: National Academies Press; 2010.
10. Eddy DM, Adler J, Morris M, The “global outcomes score”: a quality measure, based on health outcomes, that compares current care to a target level of care. Health Aff (Millwood). 2012;31: 2441–50.
11. Baker DW, Qaseem A, Evidence-based performance measures: Preventing unintended consequences of quality measurement. Annals of Internal Medicine. 2011155: 638–640.
12. Martin SA, Boucher M, Wright JM, Saini V, Mild hypertension in people at low risk. BMJ. 2014;349: g5432. doi: 10.1136/bmj.g5432 25224509
13. Krumholz HM, Lin Z, Keenan PS, Chen J, Ross JS, Drye EE, et al. Relationship between hospital readmission and mortality rates for patients hospitalized with acute myocardial infarction, heart failure, or pneumonia. JAMA. 2013/02/14 ed. 2013;309: 587–93. doi: 10.1001/jama.2013.333 23403683
14. Saver BG, Wang C, Dobie SA, Green PK, Baldwin L, The Central Role of Comorbidity in Predicting Ambulatory Care Sensitive Hospitalisations. Eur J Public Health. 2014 Feb;24(1):66–72 doi: 10.1093/eurpub/ckt019 23543676
15. Miller AB, Wall C, Baines CJ, Sun P, To T, Narod SA, Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial. BMJ. 2014;348: g366. doi: 10.1136/bmj.g366 24519768
16. Pogach L, Aron D, The Other Side of Quality Improvement in Diabetes for Seniors: A Proposal for an Overtreatment Glycemic Measure. Arch Intern Med. 2012;172: 1–3.
17. Greenhalgh T, Howick J, Maskrey N, Evidence based medicine: a movement in crisis? Bmj. 2014;348: g3725–g3725. doi: 10.1136/bmj.g3725 24927763
18. Goitein L, Virtual quality: the failure of public reporting and pay-for-performance programs. JAMA Intern Med. 2014;174: 1912–3. doi: 10.1001/jamainternmed.2014.3403 25285846
19. Romeo GR, Abrahamson MJ, The 2015 Standards for Diabetes Care: Maintaining a Patient-Centered Approach. Ann Intern Med. 2015 Jun 2;162(11):785–6. doi: 10.7326/M15-0385 25798733
20. Kruse GR, Khan SM, Zaslavsky AM, Ayanian JZ, Sequist TD, Overuse of Colonoscopy for Colorectal Cancer Screening and Surveillance. J Gen Intern Med. 2014;30: 277–283. doi: 10.1007/s11606-014-3015-6 25266407
21. Sleath JD, In pursuit of normoglycaemia: the overtreatment of type 2 diabetes in general practice. Br J Gen Pract. 2015;65: 334–335. doi: 10.3399/bjgp15X685525 26120106
22. Shaughnessy AF, Erlich DR, Slawson DC, Type 2 Diabetes: Updated Evidence Requires Updated Decision Making. Am Fam Physician. 2015;92: 22. 26132122
23. Chernew ME, Mechanic RE, Landon BE, Safran DG, Private-payer innovation in Massachusetts: the “alternative quality contract”. Health Aff (Millwood). 2011/01/07 ed. 2011;30: 51–61.
24. National Committee for Quality Assurance. Desirable Attributes of HEDIS. http://perma.cc/S5VD-QLLX
25. RTI International. Accountable Care Organization 2012 Program Analysis: Quality Performance Standards Narrative Measure Specifications. Final Report. Baltimore, MD, MD: Centers for Medicare & Medicaid Services; 2012. http://perma.cc/PG72-CQVL
26. Oxman AD, Improving the health of patients and populations requires humility, uncertainty, and collaboration. JAMA. 2012;308: 1691–2. doi: 10.1001/jama.2012.14477 23093168
27. Qaseem A, Hopkins RH, Jr.Sweet DE, Starkey M, Shekelle P, Phys AC, Screening, Monitoring, and Treatment of Stage 1 to 3 Chronic Kidney Disease: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2013;159: 835+. 24145991
28. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008;149: 627–37. 18838716
29. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;151: 716–26, W–236. doi: 10.7326/0003-4819-151-10-200911170-00008 19920272
30. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34: 2159–2219. doi: 10.1093/eurheartj/eht151 23771844
31. American Diabetes AssociationStandards of Medical Care in Diabetes. Diabetes Care. 2015;38, Supple: S1–S94.
32. Stone NJ, Robinson JG, Lichtenstein AH, Goff DC, Lloyd-Jones DM, Smith SC, et al. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med. 2014;160: 339–43. doi: 10.7326/M14-0126 24474185
33. Kmietowicz Z, Evidence to back dementia screening is still lacking, committee says. BMJ. 2015;350: h295. doi: 10.1136/bmj.h295 25596537
34. Woolhandler S, Ariely D, Himmelstein DU, Why pay for performance may be incompatible with quality improvement. Bmj. 2012;345: e5015–e5015. doi: 10.1136/bmj.e5015 22893567
35. Eddy DM, Adler J, Patterson B, Lucas D, Smith KA, Morris M, Individualized guidelines: the potential for increasing quality and reducing costs. Ann Intern Med. 2011;154: 627–34. doi: 10.7326/0003-4819-154-9-201105030-00008 21536939
36. Guthrie B, Payne K, Alderson P, McMurdo MET, Mercer SW, Adapting clinical guidelines to take account of multimorbidity. Bmj. 2012/10/06 ed. 2012;345: e6341. doi: 10.1136/bmj.e6341 23036829
37. McGlynn EA, Schneider EC, Kerr EA, Reimagining quality measurement. N Engl J Med. 2014;371: 2150–3. doi: 10.1056/NEJMp1407883 25470693
38. McShane M, Mitchell E, Person centred coordinated care: where does the QOF point us? BMJ. 2015;350: h2540. doi: 10.1136/bmj.h2540 26067130
39. Loxterkamp D, Humanism in the time of metrics—an essay by David Loxterkamp. BMJ. 2013;347: f5539. doi: 10.1136/bmj.f5539 24052583
40. Reichard J. Medicare Doc Payment Bill May Be Vehicle to Tighten Quality Measurement. In: Commonwealth Fund, Washington Health Policy Week in Review. 2013. http://perma.cc/44MD-RFDB
41. Robinson E, Blumenthal D, McGinniss JM, Vital signs: core metrics for health and health care progress. Washington DC: National Academies Press; 2015.
42. Blumenthal D, McGinnis JM, Measuring Vital Signs: an IOM report on core metrics for health and health care progress. JAMA. 2015;313: 1901–2. doi: 10.1001/jama.2015.4862 25919301
43. Madara JL, Burkhart J, Professionalism, Self-regulation, and Motivation: How Did Health Care Get This So Wrong? JAMA. 2015 May 12;313(18): 1793–4. doi: 10.1001/jama.2015.4045.25965211
44. Chew-Graham CA, Hunter C, Langer S, Stenhoff A, Drinkwater J, Guthrie EA, et al. How QOF is shaping primary care review consultations: a longitudinal qualitative study. BMC Fam Pract. 2013;14: 103. doi: 10.1186/1471-2296-14-103 23870537
45. McNamara RL, Spatz ES, Kelley TA, Stowell CJ, Beltrame J, Heidenreich P, et al. Standardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM). J Am Heart Assoc. 2015 May 19;4(5). pii: e001767. doi: 10.1161/JAHA.115.001767
46. Farne H, Publishers’ charges for scoring systems may change clinical practice. BMJ. 2015;351: h4325. doi: 10.1136/bmj.h4325 26269463
47. Davidoff F, On the Undiffusion of Established Practices. JAMA Intern Med. 2015 May;175(5):809–11 doi: 10.1001/jamainternmed.2015.0167 25774743
48. Mathias JS, Baker DW, Developing quality measures to address overuse. JAMA. 2013;309: 1897–8. doi: 10.1001/jama.2013.3588 23652520
49. Fiore MC, Baker TB, Should clinicians encourage smoking cessation for every patient who smokes? JAMA. 2013;309: 1032–3. doi: 10.1001/jama.2013.1793 23483179
50. Mahvan T, Namdar R, Voorhees K, Smith PC, Ackerman W, Clinical Inquiry: which smoking cessation interventions work best? J Fam Pract. 2011;60: 430–1. 21731922
51. Erlich DR, Slawson DC, Shaughnessy AF, “Lending a hand” to patients with type 2 diabetes: a simple way to communicate treatment goals. Am Fam Physician. 2014;89: 256, 258. 24695444
52. Khazan O. Why Don’t We Treat Teeth Like the Rest of Our Bodies? In: The Atlantic. 2014 [cited 22 May 2015]. http://perma.cc/4KCG-5LDZ
53. Friedmann PD, Clinical practice. Alcohol use in adults. N Engl J Med. 2013;368: 365–73. doi: 10.1056/NEJMcp1204714 23343065
54. Volkow ND, Frieden TR, Hyde PS, Cha SS, Medication-assisted therapies—tackling the opioid-overdose epidemic. N Engl J Med. 2014;370: 2063–6. doi: 10.1056/NEJMp1402780 24758595
55. Harris RP, Wilt TJ, Qaseem A, A value framework for cancer screening: advice for high-value care from the american college of physicians. Ann Intern Med. 2015;162: 712–7. doi: 10.7326/M14-2327 25984846
56. Hershberger PJ, Bricker DA, Who determines physician effectiveness? JAMA. 2014 Dec 24–31;312: 2613–4. doi: 10.1001/jama.2014.13304 25317546
57. American Association of Medical Colleges. Guiding Principles for Public Reporting of Provider Performance. 2014. https://www.aamc.org/download/370236/data/guidingprinciplesforpublicreporting.pdf
58. Institute of Medicine (U.S.)Committee on Standards for Developing Trustworthy Clinical Practice GuidelinesGraham R, Mancher M, Wolman DM, Clinical practice guidelines we can trust. Washington, D.C.: National Academies Press; 2011.