Comparing methods for assessing the reliability of health care quality measures

Quality measurement plays an increasing role in U.S. health care. Measures inform quality improvement efforts, public reporting of variations in quality of care across providers and hospitals, and high-stakes financial decisions. To be meaningful in these contexts, measures should be reliable and no...

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Bibliographic Details
Published inStatistics in medicine Vol. 43; no. 23; pp. 4575 - 4594
Main Authors Nieser, Kenneth J, Harris, Alex H S
Format Journal Article
LanguageEnglish
Published England 15.08.2024
Subjects
quality measurement
quality of care
reliability
performance measurement
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Summary:Quality measurement plays an increasing role in U.S. health care. Measures inform quality improvement efforts, public reporting of variations in quality of care across providers and hospitals, and high-stakes financial decisions. To be meaningful in these contexts, measures should be reliable and not heavily impacted by chance variations in sampling or measurement. Several different methods are used in practice by measure developers and endorsers to evaluate reliability; however, there is uncertainty and debate over differences between these methods and their interpretations. We review methods currently used in practice, pointing out differences that can lead to disparate reliability estimates. We compare estimates from 14 different methods in the case of two sets of mental health quality measures within a large health system. We find that estimates can differ substantially and that these discrepancies widen when sample size is reduced.
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content type line 23
ISSN:0277-6715
1097-0258
1097-0258
DOI:10.1002/sim.10197