Increasingly, tools and surveys are employed to determine current and optimal levels of health care service and performance, and ultimately to improve the levels for each. RAND helps policymakers, health care leaders, and practitioners determine cost-effective and accurate ways to measure the quality of health care being provided, and then recommends ways to improve the level of health care quality.
Instruments and scoring instructions for many major health services surveys are available from the RAND Health website, as well as practical tools for improving quality of care.
The quality of clinical care and the quality of interpersonal care should be considered separately to give an overall assessment of medical care.
Transparency varies across websites that provide information on the performance of medical providers. This is especially true of how providers can review or correct results, how case mix adjustments are made, and how the reliability of measures is assessed.
RAND is engaged in developing and supporting the use of quality measures by the Centers for Medicare & Medicaid Services (CMS)
A ranking methodology can provide a general indication of the quality of institutions applying to be deemed Academic Health Science Centres in England.
A team from RAND and the University HealthSystem Consortium (UHC) developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality.
In this chapter, we present the PBOA instruments that have been used to determine outcomes in acupuncture clinical research, and highlight measures that are feasible, practical, economical, reliable, valid, and responsive to clinical change.
While the current state of the evidence does not provide clear guidance to policymakers seeking to address the twin pillars of health care quality and cost, it is apparent that researchers must produce more detailed data on how to reduce health care spending while improving quality, writes Peter Hussey.
California health regulators should begin collecting physician identifiers as part of their routine data collection efforts about the services provided at the state's hospitals. Such a move would help providers improve quality by aiding efforts to benchmark performance and reduce variations in the delivery of care.
To be wise purchasers of health care services, consumers need access to accurate and understandable information about health plans and providers. They wrongly assume that more expensive providers are better than less expensive ones, despite inconsistent evidence that there is any link between health care cost and quality.
A review of more than 60 studies reveals extremely mixed findings on the association between health care quality and cost. Future work should determine what types of spending effectively improve quality and what types are wasteful.
The use of a generic survey did not appear to affect either unit or item response rates, and did not appear to affect the ways in which beneficiaries evaluate various aspects of their care experiences.
The authors explore the expectations of prolapse surgery held by women before that surgery and to examine reasons why such expectations were met, or not met.
Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys are designed to capture patients' experiences in a systematic way that facilitates reporting the results publicly to help other consumers make more savvy care decisions. Consumer choices may influence providers to improve the care they offer so that they can effectively compete in the market.
Translating empirical studies, systematic reviews, and clinical guidelines into measurable performance indicators is a key first step in improving the quality of care.
Cost-sharing leads consumers to reduce both highly beneficial and less beneficial care, so they must be empowered with useful information to make informed decisions. Public cost and quality reports must be accurate, accessible, and understandable.
In its second term, the Obama Administration can restrain further health care spending growth—without compromising quality—by employing four broad strategies: fostering efficient and accountable providers, engaging and empowering consumers, promoting population health, and facilitating high-value innovation.
Hospitals with higher cultural competency ratings have better scores on multiple dimensions of care. Findings also indicate that greater cultural competency may particularly benefit minorities in interactions with hospital staff, while also contributing to general quality improvement.
As indicators of clinician quality proliferate, public reports increasingly include multiple metrics. This approach provides more complete performance information than did earlier reports but may challenge consumers' ability to understand and use complicated reports.