course hero which statement is true about outcome measures?

Background

In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare & Medicaid Services (CMS) and Hospital Quality Alliance (HQA) began publicly reporting 30-day mortality measures for acute myocardial infarction (AMI) and heart failure (HF) in June 2007 and for pneumonia (PN) in June 2008.

Additional Analyses

In addition to calculating the above measures for public reporting, CMS also conducts annual analyses of its hospital outcome measures to provide greater insight into measure trends and variation. These additional analyses use calculations reported annually on Hospital Compare and are compiled in the Chartbook as described below.

Hospital Performance Reports: Chartbook Series

The CMS Hospital Performance Reports present analyses that provide insight into hospital performance on publicly reported outcomes measures for patients. The Chartbook provides new information about recent trends and variation in outcomes by location, hospital characteristics, patient disparities, and cost.

What are the characteristics of an outcome measure?

Important features of an outcome measure that need to be taken into account when using an outcome measure are its psychometric properties. Psychometric properties are the intrinsic properties of an outcome measure. Ideally, the psychometric properties of an outcome measure used in practice should have been developed and tested through a series of research studies. These properties include validity, inter-rater reliability, intra-rater reliability, responsiveness, ceiling effects, floor effects and minimal clinically important difference. Validity refers to the how accurately the test actually measures what it is supposed to measure. High validity means the measure is consistently stable in its ability to measure its intended focus. Inter-rater reliability takes into consideration the consistency of the results of the measure when two different people are evaluating the results of a common subject. With performance-based measures, if two physiotherapists scored the performance, high inter-rater reliability would mean that both determined similar scores on the performance evaluated. For patient reported outcome measures, a high intra-rater reliability indicates that the patient consistently responds to attain the same results. (This would be more relevant with serial testing and no intervention or change in status. Intra-rater reliability falls under test-retest reliability.) Responsiveness refers to the ability for the measure to be able to capture change in status. Ceiling effect occurs when the majority of patients are able to complete the measure and score within the highest range of the measurement. (The test is too easy and is not capturing their full capability.) Floor effect occurs when the majority of the patients score within the lowest range of the measurement. (The test is too hard and does not have enough easier items to distinguish varying levels of status.) When determining if change is relevant, the p-value has no value. For outcome measures, the clinician needs to know the minimal important difference. Minimal important difference refers to the amount of change that is relevant from the patient's perspective. ( clinical meaningfulness ).

What is outcome measure?

An outcome measure is a tool used to assess a patient’s current status. Outcome measures may provide a score, an interpretation of results and at times a risk categorization of the patient. Prior to providing any intervention, an outcome measure provides baseline data. The initial results may help determine the course of treatment intervention. Once treatment has commenced, the same tool may be used in serial assessments to determine whether the patient has demonstrated change. With the move towards Evidence Based Practice (EBP) in health care, outcome measures provide credible and reliable justification for treatment on an individual patient level. The results from outcome measures may also be grouped for aggregated analysis focused on determining quality of care. When outcome measures are used in an aggregated data situation to compare results, a risk adjustment process is required to fairly compare results.

What are the psychometric properties of outcome measures?

These properties include validity, inter-rater reliability, intra-rater reliability, responsiveness, ceiling effects, floor effects and minimal clinically important difference.

What is the outcome measurement information system?

Outcomes Measurement Information System: PROMIS: provides a web-based repository of valid and reliable PRO measures of health concepts relevant to clinician and researchers.

What is the difference between patient reported and performance based measures?

Performance-based measures and patient reported measures both capture a current status. These measures do not typically equate with each other. Performance-based measures tend to bring to light physiologic factors. Patient reported outcome measures may capture a patient's perception, beliefs, social factors and/or health factors.

What is a rehabilitation measures database?

Rehabilitation measures database : developed to help clinicians and researchers identify reliable and valid instruments used to assess patient outcomes during all phases of rehabilitation.

What is an observer-reported measure?

Observer-reported measures are measurements completed by a parent, caregiver or someone who regularly observes the patient on a daily basis.