Review of the Current Literature on Outcome Measures Applicable to the Medicare Population for Use in a Quality Improvement Program

Project Deliverable 2a, 2b

by Susanne Hempel, David A. Ganz, Megan Clifford, Sydne Newberry, Yee-Wei Lim, Jody Larkin, Roberta M. Shanman, Samuel Wertheimer, Neil S. Wenger, Carol P. Roth, Paul G. Shekelle

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This paper reviews measures that have been used to assess quality improvement programs in Medicare or equivalent populations. The authors searched MEDLINE for evaluations of quality improvement programs for applicable populations in US settings published between 2000 and October 2010. The definition of a quality improvement program they adopted was "a change in how routine care is delivered." Available publications reporting on effects of interventions with concurrent control groups, or before-and-after studies, were eligible for inclusion in the review. They used methods to minimize reviewer error and bias throughout to provide a reliable, valid, and transparent overview, but this scoping review does not constitute a comprehensive systematic review. The search identified 2,786 publications, of which 690 were considered potentially relevant based on the title and abstract. Of these, 539 were obtained and screened as full text publications. In all, 180 publications met inclusion criteria and were abstracted. The study details are documented in an evidence table. Studies reported on patient health status outcomes, other patient and caregiver measures such as satisfaction with care, and provider and organizational measures such as costs or quality indicators satisfied. The existing literature demonstrates a wide variety of potential outcome measures, each with inherent advantages and disadvantages. Thus, a transparent and valid strategy is needed to select measures that will be useful for evaluating quality improvement programs applicable to the Medicare population.

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