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Measuring Psoriasis Severity at Home

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Addressing physician concerns about performance profiling: experience with a local Veterans Affairs quality

Sony Ta¹, Caroline Goldzweig, Michael Juzba

¹UCLA Department of General Internal Medicine and Health Services Research, Los Angeles, CA, USA. sonyta@mednet.ucla.edu

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality

|February 21, 2009

Summary

Adding new quality measures and statistics to clinician feedback improved diabetes care profiling in Veterans Affairs (VA) clinics. Performance variations were significant, but risk adjustment had minimal impact.

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Published on: July 11, 2025

Area of Science:

Healthcare Quality Improvement
Diabetes Care Management
Health Services Research

Background:

Clinician feedback initiatives are crucial for improving healthcare quality.
Profiling diabetes care in Veterans Affairs (VA) clinics requires robust performance indicators.
Existing feedback mechanisms may benefit from enhanced metrics and statistical analysis.

Purpose of the Study:

To evaluate the impact of novel quality indicators and risk adjustment on diabetes care profiling.
To assess performance variations among 13 Veterans Affairs (VA) clinics.
To determine if enhanced statistical methods improve the characterization of clinical performance.

Main Methods:

Extracted data from a computerized database for calendar years 2004-2005.
Assessed performance using 10 quality measures: 4 monitoring, 3 intermediate outcomes, 3 treatment.
Employed multivariate logistic models to analyze risk adjustment and clinic performance variation.

Main Results:

Lower attainment rates and greater clinic-level variation were observed for less familiar quality indicators.
Statistically significant performance variations, some clinically important, were detected among clinics.
Risk adjustment did not substantially alter the assessment of clinic performance.

Conclusions:

The addition of clinically relevant quality measures and simple statistics enhanced the characterization of diabetes care performance.
Significant variations in care quality exist across Veterans Affairs (VA) clinics.
Further refinement of quality indicators and feedback methods is warranted for optimal diabetes care.