Getting the measure of quality
Opportunities and challenges
Catherine Foot, Senior Fellow in the policy directorate at The King’s Fund. She is currently managing a programme of work on delivering the quality agenda
The King’s Fund 2010
Available online PDF [36p.] at: http://www.kingsfund.org.uk/research/publications/quality_measures.html
“……Another aspect of quality that has received relatively little focus in the context of the quality measurement initiatives following the Next Stage Review is that of inequalities.
Health care (preventive and curative) should be provided on the basis of clinical need, regardless of personal characteristics such as age, gender, ethnicity, disability, religion, sexual orientation, socio-economic status or geographical location, and it should aim to reduce differences in health status, access to services and outcomes across population sub-groups.
Equality legislation also mandates requirements for equity, and the Marmot Review has put a renewed focus on health inequalities (Strategic Review of Health Inequalities in England 2009).
1 Defining quality: what are we measuring?
Domains of quality
Efficiency, productivity and value for money
Equity and health inequalities
Measurement across pathways and between organisations
Not everything that matters can be measured
2 Who uses quality measures and for what purpose?
Audiences for measures of quality
The aims of measurement should determine what and how we measure
Interpretation matters: what measures of quality can and can’t tell you
The importance of a coherent policy framework for quality improvement
3 The potential impact of measuring quality
Use for measurement to improve the quality of health care
International comparisons and benchmarking
Potential for unintended consequences
4 Practical issues to consider when choosing and using quality measures
Selection of indicators
Data sources: current versus new
Data coverage and quality
Reporting on data quality
Some methodological and related issues
Centrally versus locally produced indicators
Evaluating and refining indicators
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