Using "Roll-up" Measures in Healthcare Quality Reports
Perspectives of Report Sponsors and National Alliances
Published in: The American Journal of Managed Care, Volume 23, No. 6, pages e202-e207
Posted on RAND.org on July 14, 2017
- What are some current report sponsor practices in reporting "roll-up" measures of health care quality, which combine indicators of multiple, often disparate, dimensions of care?
- Among report sponsors and national alliances representing stakeholder groups affected by quality reporting, what are the perceived benefits and drawbacks for reporting roll-up measures of health care quality?
To understand the views of prominent organizations in the field of healthcare quality on the topic of reporting roll-up measures that combine indicators of multiple, often disparate, dimensions of care to consumers.
This study used a semi-structured, qualitative interview design.
We conducted 30- to 60-minute semi-structured telephone interviews with representatives of 10 organizations that sponsor public healthcare quality reports and 3 national alliances representing multiple stakeholder groups. We conducted a thematic analysis of interview transcriptions to identify common issues and concerns related to reporting roll-up measures.
Among sponsors reporting roll-up measures, current practices for calculating and reporting these measures are diverse. The main perceived benefit of reporting roll-up measures is that they simplify large amounts of complex information for consumers. The main concern is the potential for consumers to misunderstand the measures and what associated roll-up scores communicate about provider performance. Report sponsors and national alliances feel that more guidance and research on the methods for producing and reporting scores for roll-up measures are needed.
The results of the interviews elucidate the need for research focused on construction and reporting of roll-up measures. Studies are needed to determine if roll-up measures are indeed perceived by consumers as being less complex and easier to understand.
- Report sponsors' practices for calculating and reporting these measures are diverse.
- Report sponsors and national alliances representing stakeholder groups affected by quality reporting feel that roll-up measures simplify large amounts of complex information for consumers, but consumers may misunderstand the aspects of quality captured by roll-up measures and what they communicate.
- Report sponsors and national alliances report needing more guidance and research on how to produce and report scores for roll-up measures.
- The findings in this manuscript point to the need for a research agenda focused on developing standards for the construction, calculation, and reporting of roll-up measures that are rooted in empirical data on how constructs assessed by various performance measures relate to each other and desired health outcomes.
- The findings also highlight the need for building the body of published research on consumer use of and responses to roll-up measures.