Table of Contents | Envisioning the National Health Care Quality Report | Committee on the National Quality Report on Health Care Delivery | Board on Health Care Services

Margarita P. Hurtado, Elaine K. Swift, and Janet M. Corrigan, Editors

Title Page and Notice		i
National Academies Statement		iii
Committee		iv
Preface		ix
Acknowledgements		xi

EXECUTIVE SUMMARY		1

1	INTRODUCTION	19
	Origins of the National Health Care Quality Report	20
	The IOM Committee on the National Quality Report on Health Care Delivery	20
	Defining Health Care Quality	22
	Recent Initiatives on Health Care Quality and Quality Reporting	22
	Other National and International Initiatives on Health Care Quality Measurement	24
	Quality Measurement and Reporting in Other Sectors	29
	Objectives of the National Health Care Quality Report	30
	Organization of the IOM Report	34

2	DEFINING THE CONTENTS OF THE DATA SET: THE NATIONAL HEALTH CARE QUALITY FRAMEWORK	40
	Recommendation	40
	Importance of the Framework	42
	National Health Care Quality Framework	42
	Summary	66

3	SELECTING MEASURES FOR THE NATIONAL HEALTH CARE QUALITY DATA SET	76
	Recommendations	76
	Examining Potential Measure Selection Criteria	80
	Criteria for Selecting Individual Measures for the National Health Care Quality Data Set	80
	Evaluation Criteria for the National Health Care Quality Measure Set	88
	Measure Selection Process	90
	Measuring Health Care Quality Comprehensively	93
	Types of Measures	94
	Summary	98

4	DATA SOURCES FOR THE NATIONAL HEALTH CARE QUALITY REPORT	103
	Recommendations	104
	Data Source Selection Criteria	106
	Potential Data Sources	109
	Evaluating Data Sources for the National Health Care Quality Data Set in the Short Term	118
	Data Sources for the National Health Care Quality Report	129
	Increasing Access to the National Health Care Quality Data Set	133
	Summary	133

5	DESIGNING THE NATIONAL HEALTH CARE QUALITY REPORT	139
	Recommendation	139
	Audiences for the National Health Care Quality Report	140
	Report Guidelines	141
	Audience Testing the National Health Care Quality Report	150
	Promoting the Quality Report	152
	Summary	155

APPENDICES

A	Workshop: Envisioning a National Quality Report on Health Care	159

B	Designing a Comprehensive National Report on Effectiveness of Care: Measurement, Data Collection, and Reporting Strategies	167

C	Submissions in Response to the Committee's Call for Measures from the Private Sectors	179

D	Selected Approaches to Thinking About the National Health Care Quality Report	189

E	Quality Measure Selection Criteria	212

GLOSSARY		223

ACRONYMS AND ABBREVIATIONS		225

BIOGRAPHICAL SKETCHES OF COMMITTEE MEMBERS		228


	TABLES, FIGURES, AND BOXES
	Tables
2.1	Components of Health Care Quality and Their Subcategories	44
2.2	Comparison of Priority Conditions in MEPS and Healthy People 2010	60
3.1	Most Common Criteria for Measure Selection Proposed by Other Groups	81
4.1	Preliminary Evaluation of Public Data Sources on Health Care Quality	120
4.2	Preliminary Evaluation of Private Data Sources on Health Care Quality	122
B.1	Clinical Areas Included in QA Tools System by Population Group Covered	170
B.2	Summary of the QA Tools Indicators by Type of Care, Function of Care and Modality	172
B.3	Sample Indicators from QA Tools System	173

	Figures
1	Classification matrix for measures for the National Health Care Quality Report	8
1.1	From the National Health Care Quality Framework to the National Health Care Quality Report	35
2.1	Consumer perspectives on health care needs	55
2.2	Classification matrix for measures for the National Health Care Quality Report	61
B.1	An illustration of how to present QA Tools summary results	176
B.2	An illustration of how to present condition-specific scores within chronic care categories	177
D.1	Model of the determinants of health	196

	Boxes
1.1	Selective Quality Reporting in Pennsylvania	27
1.2	The United Kingdom's National Health Service Quality Performance Reports	29
1.3	The National Assessment of Educational Progress	30
1.4	Healthy People 2010 Focus Areas	33
2.1	Examples of Areas in Which Measures of Safety May Be Applied and Selected Measures	45
2.2	Examples of Areas in Which Effectiveness Measures May Be Applied and Selected Measures	48
2.3	Examples of Areas in Which Measures of Patient Centeredness May Be Applied and Selected Measures	52
2.4	Examples of Areas in Which Measures of Timeliness May Be Applied and Selected Measures	54
2.5	Sample Measures of Quality of Breast Cancer Care by Consumer Health Care Needs	58
2.6	Questions Addressed by the National Health Care Quality Report	65
3.1	Desirable Characteristics of Measures for the National Health Care Quality Report	83
3.2	Steps in the Process of Defining the National Health Care Quality Measure Set	91
3.3	Toward an Ideal Measure Set	98
4.1	Desirable Attributes for Sources for the National Health Care Quality Data Set	106
5.1	Guidelines on Presenting Information in the Quality Report	143
5.2	New-Style Annual Business Reports: How to Serve Generalists and Specialists	144
5.3	Maryland Health Care Commission's Health Maintenance Organization Quality and Performance Reports: Different Versions for Different Audiences	145
5.4	Keeping an Annual Report Fresh: AARP's State Profiles on Health Care	149
5.5	Newspaper Coverage of the National Health Service Performance Indicators	153