Abstract

September 2005

Section Clinical Essentials

Performance in health care is the degree to which desirable objectives are accomplished. Performance measurement can inform quality-improvement activities and allow health care consumers and commercial health care purchasers to hold physicians and health care organizations accountable for the services they provide. At present, the vast majority of patients in the United States who are enrolled in managed-care organizations or Medicare receive health care from health plans, hospitals, nursing homes, or ambulatory care centers for which publicly reported performance data are available; the trend toward the public release of performance information is likely to accelerate in coming years. Experts caution physicians that they must be leaders in quality measurement and performance improvement or be vulnerable to challenge by economic or political stakeholders and to the potential loss of patient confidence. By understanding the types of measures by which they will be judged and knowing how the data are collected, physicians will be in a better position to respond to the accountability that is a fundamental aspect of quality-performance measures. This chapter presents arguments why quality-performance measures should be undertaken, the various measures of performance (i.e., measures of clinical performance, patient satisfaction and experience, and efficiency); methodological issues involved in performance measurement; and implications of quality measurement to the individual physician. A sidebar lists Internet resources for common performance measures. This chapter has 38 references.

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