Outcome Measures for the Assessment of Hospital Care

摘要

The report (1) examines the value, potential, and limitations of Medicare claimsdata and functional status measures for valuating the effectiveness of medical practices and the quality of care provided to Medicare recipients, and (2) identifies the relevant health outcomes for breast cancer, hip fracture, and myocardial infraction. The findings were: Claims data have great potential as a means to assess health care outcomes and contribute to the evaluation of the effectiveness of medical practices and the quality of care provided. However, at present such use of claims data should be considered investigational and preliminary. The major factors limiting the validity and generalizability of claims data include issues of inaccuracy and inadequacy of coding and inadequate methods to adjust for case mix. The logistic complexities of routinely obtaining functional status data at the time are great. Use of these measures are best limited, for the foreseeable future, to propsectively selected patient samples under study to determine the effectiveness of specific medical practices.