Int J Qual Health Care-2001-Rubin-469-74

Larger sample is usually needed for comparisons among

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Unformatted text preview: rm such as five- or ten-year survival requiring long period of observation Due to need for risk adjustment a larger sample is usually needed for comparisons among providers or treatments Requires follow-up for measurement of short- and long-term outcomes at time when routine data collection not occurring Often requires collection of data elements that are not being recorded for clinical or billing purposes such as longterm survival or patient-reported health and well-being on standardized scales Needed to create risk adjustment models and evaluate them when analyzing data Validity What patients care about Often inaccessible to patients who often do not understand the significance of a specific component of care What providers care about Face validity with providers; relates directly to what the provider is doing The generic outcomes of survival, health and well-being are what patients care about and measures of these can be used to validate process changes. More specific or proxy outcomes may not be accessible to patients Providers are wary of outcome measures that are influenced by many other things besides what they do; must measure performance of risk adjustment models Ease of use Ease of specification and identification of population at risk Creation of valid summary measures Interpretability of feedback for quality improvement Difficult to specify population eligible for a process; there can be many exclusions, contraindications and special outcomes, and many important process measures are specific for a single disease Difficult to summarize process measures in a valid way as they are rarely comprehensive Provides clear and interpretable feedback for quality improvement about what providers are actually doing; easy to benchmark Easy to define population for which want to measure an outcome; many important outcomes are generic and can be compared across several conditions Many important outcome measures, such as survival, health and well-being, are both global and generic and can be compared across conditions and processes Most measures cannot be used to give feedback to providers about how to improve what they are doing as rarely is an outcome always a consequence of a particula...
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