Evaluating the Quality of Health Care

9. Selecting Measures

Patient surveys can be used for many purposes in quality studies, but the main uses are to assess outcomes and processes from the patient’s perspective, or the extent to which care is “patient centered.” The outcomes of treatment are central to patients. As a result, many consider what is generally referred to as Health Related Quality of Life (HRQL), along with survival, key criteria of high quality medical care. In the ambulatory setting, these sorts of data are particularly important because ambulatory medical care is often directed at reducing morbidity more than decreasing mortality.

An advantage of asking patients directly for information about outcomes is that this type of information is less susceptible to "gaming", or biased reporting to improve reimbursement or apparent performance, by providers. Patients certainly can be influenced by their providers and there are biases inherent in the way patients report information but the risk of "gaming" is lower than for information provided by physicians or nurses.

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