A Quick Look at Quality
                                       
   Contents
         > What is Measured?
         > What Should I Look For?
   
   Quality health care means doing the right thing, at the right time, in
   the right way, for the right person-and having the best possible
   results.
   
   Although we would like to think that every health plan, doctor,
   hospital, and other provider gives high-quality care, this is not
   always so. Quality varies, for many reasons.
   
   Fortunately, there are scientific ways to measure health care quality.
   These tools, called measures, have mostly been used by health
   professionals. They use measures to check up on and improve the
   quality of care they provide.
   
   But there is some quality information you can use right now to help
   you compare your health care choices. And more and more is becoming
   available all the time. Many public and private groups are working to
   improve and expand health care quality measures. The goal is to make
   these measures more reliable, uniform, and helpful to consumers in
   making health care choices.
   
                            What is Measured?
                                      
   There are two main types of quality measures that can help you choose
   quality health care: consumer ratings and clinical performance
   measures. Both types are based on "outcomes research."
   
   Outcomes research measures the end results of health care practices
   and treatments. For example, after treatment, is the pain gone? Can
   the patient carry out his or her daily activities? Is he/she satisfied
   with his or her care?
   
   Consumer ratings (or "consumer satisfaction" information). These look
   at health care from the consumer's point of view. For example, do
   doctors in the plan communicate well? Do members get the health
   services they need?
   
   Many consumer ratings of health plans are based on a survey called the
   Consumer Assessment of Health Plans (CAHPS®) and on the Health Plan
   Employer Data and Information Set (HEDIS) member satisfaction survey,
   which includes CAHPS® questions.
   
   Clinical performance measures (also sometimes called "technical
   quality" measures). Some widely used clinical performance measures are
   included in HEDIS. These measures look at how well a health care
   organization prevents and treats illness. For example, one HEDIS
   clinical performance measure looks at whether children get the
   immunizations (shots) they need when they need them.
   
   More information on CAHPS® and HEDIS are provided in the Choosing a
   Health Plan section.
   
                       What Should I Look For?
                                      
   Quality Reports. You may be able to find consumer ratings, clinical
   performance measures, or both in quality reports. Quality reports go
   by different names, including performance reports and report cards.
   Quality reports don't tell you which health care choices are the best.
   But they can help you decide which are best for you, based on the
   things that are most important to you.
   
   More information about quality reports is provided in the Choosing a
   Health Plan and Choosing a Hospital sections.
   
   Accreditation Reports. Another way to compare quality is to use
   information about accreditation. Accreditation is a "seal of
   approval." It is mainly used for health care organizations such as
   health plans, hospitals, and nursing homes.
   
   To earn accreditation, organizations must meet national standards,
   often including clinical performance measures. Organizations choose
   whether to participate in accreditation programs. Therefore, you will
   not find accreditation information on every nursing home, for example.
   
   More information on accreditation is provided in the Choosing a Health
   Plan, Choosing Treatments, Choosing a Hospital, and Choosing Long-Term
   Care sections.
   
   
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   Current as of July 2001
   
   Send Questions & Comments to: info@ahrq.gov
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   Internet Citation:
   
   A Quick Look at Quality. Your Guide to Choosing Quality Health Care.
   AHCPR Publication No. 99-0012,  July 2001. Agency for Healthcare 
   Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/qntascii/
   qntqlook.htm
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