[Hospital quality measurement—what matters?]

Area of Science:

• Health Services Research
• Public Health Policy
• Healthcare Management

Background:

• Hospital quality measurement in Germany has evolved from internal assurance to public reporting.
• Emerging trends include quality-based purchasing, necessitating more robust quality metrics.
• Current quality indicators require enhancement to be more comprehensive, outcome-focused, and tamper-resistant.

Purpose of the Study:

• To explore the evolving landscape of hospital quality measurement in Germany.
• To identify new requirements for quality indicators driven by policy changes.
• To assess the potential of administrative data for improving hospital quality measurement.

Main Methods:

• Analysis of the evolution of hospital quality measurement aims in Germany.
• Evaluation of the characteristics of ideal quality indicators (comprehensive, outcome-related, tamper-resistant).
• Assessment of the utility and limitations of administrative data for quality measurement, considering low case numbers.

Main Results:

• Administrative data offer a viable solution for comprehensive, outcome-related, and tamper-resistant quality measurement.
• Using administrative data can extend quality measurement to new conditions without increased effort or cost.
• Provider-independent quality measurement is facilitated by administrative data, though it may lead to political debate.

Conclusions:

• Administrative data are crucial for establishing nationwide, long-term hospital outcome measurements.
• Despite potential political challenges, administrative data enhance hospital quality assessment.
• Outcome-related quality measurements, particularly when using administrative data, improve hospital care through internal quality management.