Purchaser quality measures: progressing from wants to needs

Purchaser demands for hospital performance data are based on the fundamental nature of benefits management-the need to reconcile costs and results. The evolution from cost-based delivery of services to prospectively priced, value-based services is occurring concurrently with the adoption of quality improvement approaches.

The "wants" for data that purchasers articulate sometimes hide the "needs" the wants were meant to satisfy. A more efficient information agenda can be developed by exploring the nature of these needs for patients, who receive the benefits, and purchasers, who pay for them. Characteristics such as sensitivity, importance, feasibility, validity, and believability for outcome measures are discussed and then used to evaluate three popular measures of quality: cesarean section (C-section), mammography screening, and coronary artery bypass graft mortality rates.

By focusing on disease/treatment/outcome-specific measurement systems, information sets helping patients, providers, and purchasers to achieve the best possible quality of outcome can be efficiently developed.