Patient-Based Quality Assessment for Chronic Disease. abstract, Executive Summaryand Final Report

摘要

The purpose of this grant was to examine the usefulness of patient report inproviding information on quality of care. We asked these questions: Are patient reports accurate in relation to claims data. Do disease specific outcome provide better discrimination between health plans than generic measures such as SF-36. Can a patient based measure of case mix, the Total Illness Burden Index, which is patient reported and independent of diagnosis, be used to adjust quality indicators, including satisfaction, functional status and utilization. We tested these questions in a national sample of 10,360 patients in six cities, using a patient survey and a well developed claims database. There were 5,188 patients who had matched survey and claims records. We conclude, from this research, that patient report can be used as 'case finding,' indicating the need to seek more information only if the patient answers positively. This could reduce the amount of chart review necessary. We also conclude that disease specific outcomes are more useful than generic measures in comparing health plans. These disease specific measures can be aggregated across diseases. Finally, patient report of clinical severity of illness, the Total Illness Burden Index, a measure that is independent of diagnosis, can be used to adjust quality measures.