Minding the Gaps: Measuring Quality Based on Episodes of Care
May 6, 2016
Developing an episode-based framework of health care quality measurement would allow for more comprehensive assessments of care quality than currently available methods.
Published in: Medical Care Research and Review, 2016
Posted on RAND.org on February 29, 2016
Most currently available quality measures reflect point-in-time provider tasks, providing a limited and fragmented assessment of care. The concept of episodes of care could be used to develop quality measurement approaches that reflect longer periods of care. With input from clinical experts, we constructed episode-of-care frameworks for six illustrative conditions and identified potential gaps and measure development priority areas. Episode-based measures could assess changes in health outcomes ("delta measures"), the amount of time during an episode in which a patient has suboptimal health status ("integral measures"), quality contingent upon events occurring previously ("contingent measures"), and composites of measures throughout the episode. This article identifies a number of challenges that will need to be addressed to advance operationalization of episode-based quality measurement.
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