Developing a Clinical Performance Measure

• Published in: American journal of preventive medicine Vol. 14; no. 3; pp. 14 - 21
• Main Authors: McGlynn, Elizabeth A., Asch, Steven M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.04.1998
• Subjects: Adolescent; Adult; Aged; chronic disease; Cost-Benefit Analysis; Diagnosis-Related Groups - classification; Evidence-Based Medicine; health care; Humans; Hypertension - prevention & control; Managed Care Programs - standards; Medical Subject Headings (MeSH); Middle Aged; Program Development; quality assessment measurement; Quality Indicators, Health Care - organization & administration; Reproducibility of Results; Research Design; Severity of Illness Index; task performance and analysis; United States; United States; task performance and analysis; quality assessment measurement; Medical Subject Headings (MeSH); chronic disease; health care
• ISSN: 0749-3797; 1873-2607
• DOI: 10.1016/S0749-3797(97)00032-9

Background: Clinical performance measurement is an increasingly important way for public and private purchasers alike to compare the value of health services provided by competing health delivery systems. The widespread use of performance measures has increased the demand for development of new measures that cover previously unevaluated aspects of care. Methods: Four steps required to develop a clinical performance measure that is suitable for making comparisons among health delivery systems are discussed: (1) choosing clinical areas to measure, (2) selecting performance indicators within each area, (3) designing specifications for consistent implementation of a measure, and (4) evaluating the scientific strength of a measure. Results: The application of these steps to developing measures of quality for hypertension is provided, with an emphasis on a measure of adequacy of control of blood pressure. Conclusions: Developing useful clinical performance measures requires careful attention to methodologic issues. Following the steps outlined in this paper should enhance the quality of future measurement development.