Developing a Reliable, Valid, and Feasible Plan for Quality-of-Care Measurement for Cancer

How Should We Measure?

Published in: Medical Care, v. 40, no. 6, suppl., June 2002, p. III-73- III-85

Posted on RAND.org on January 01, 2002

by Katherine L. Kahn, Jennifer Malin, John L. Adams, Patricia A. Ganz

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BACKGROUND. Recent changes in the US health care delivery system have raised expectations that the medical marketplace will compete on quality and cost of care. This effort will require a systematic evaluation of the measurement of quality of care as it applies to cancer and other critical conditions. OBJECTIVES. To articulate the components of the design of quality-of-care measurement systems that must be considered and optimally manipulated to generate feasible, reliable, and valid data pertinent to patients with cancer. RESEARCH DESIGN. A synthesis of information obtained from literature reviews and experience. MEASURES. Four key areas of design that influence quality-of-care measurement scores are discussed: case identification, data source, data-collection strategies, and the quality of the care-measurement model. RESULTS. Challenges associated with these design and measurement strategies are defined and discussed. CONCLUSIONS. Policy analyses vary as a function of measurement domains. The design of a quality-of-care measurement system should consider trade-offs between validity and burden by considering the intricate relations between domains of measurement.

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