Candidate Measure Submission Form (CPCF)
CHIPRA Pediatric Quality Measures Program (PQMP)
Section XV: Glossary of Terms
Term # | Term | Definition | Sources |
---|---|---|---|
1. | DENOMINATOR | The number or population representing the total universe in which an event might happen: the number at risk used to calculate a rate, proportion, or percentage. | Cohn, 2001 |
2 | MEDICAL GROUP | A medical group is a self-defined "parent" provider organization which may exist within a broader network structure and is generally comprised of multiple practice sites, but can represent a single, large multi-specialty practice site.
| PQMP Result Aggregation Workgroup, 2012 |
3 | NETWORK | A network is an overarching affiliation of medical groups and/or practice sites with an integrated approach to quality improvement that health plans regard as a contracting entity for these provider organizations.
| PQMP Result Aggregation Workgroup, 2012 |
4 | NUMERATOR | A subset of those in the denominator who have experienced the event of interest (e.g. death, morbidity, screening) used to calculate a rate, proportion, or percentage. | RTI |
5 | OUTCOME | A particular state of health, often defined for purposes of quality measurement as a result of the performance (or nonperformance) of functions or processes of care. | Adapted from CMS |
6 | OUTCOME MEASURE | Measure that indicates the results of the performance (or nonperformance) of functions or processes. A measure that focuses on achieving a particular state of health. | CMS |
7 | PROCESS MEASURE | Measure that focuses on a healthcare process that leads to a certain outcome. For a process measure to be valid, a scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome. | Adapted from CMS |
8 | PRACTICE SITE | A practice site is one or a group of providers who practice together at a single location (i.e., same mailing address down to the Suite # level).
| Adapted from National Committee on Quality Assurance's practice site methodology |
9 | PROCESS (of care) | Process of care denotes what is actually done to the patient in the giving and receiving of care. As examples: the provider could immunize the patient against a communicable disease; the provider could prescribe a medication for the patient; the provider could screen an asymptomatic patient for developmental disorders. | Adapted from IOM, 2006, Appendix E |
10 | PROVIDER | Provider is any individual, organization, facility or group that delivers direct health care to children; depending on the measurement context, this may be a hospital, medical group, or individual clinician. | PQMP Result Aggregation Workgroup, 2012 |
11 | QUALITY (in health care) | Health care quality has been defined in several ways. In 1990, the Institute of Medicine (IOM) defined quality as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (IOM, 1990). Eisenberg defined quality as the right care for the right person at the right time in the right way. In 2001, the IOM defined quality as having six aims: Safety, Timeliness, Effectiveness, Equity, Efficiency, and Patient-Centeredness. The Affordable Care Act defines quality of care as a measure of performance on IOM's six aims for health care. CHIPRA defines a clinical quality measure as "a measurement of clinical care that is capable of being examined through the collection and analysis of relevant information, that is developed in order to assess one or more aspects of pediatric health care quality in various institutional and ambulatory health care settings, including the structure of the clinical care system, the process of care, the outcome of care, or patient experiences in care." | IOM, 2001; IOM, 1990; Eisenberg, 1997; CHIPRA, 2009; Patient Protection and Affordable Care Act, 2010 |
12 | QUALITY MEASURE | A quality measure is in effect a rule (or the result of a rule) that assigns numeric values to a specific quality indicator. Quality measures generally consist of a descriptive statement or indicator, a list of data elements necessary to construct and/or report the measure, detailed specifications that direct how the data elements are to be collected (including the source of data), the population on whom the measure is constructed, the timing of data collection and reporting, the analytic models used to construct the measure, and the format in which the results will be presented. | Adapted from IOM, 2006, Appendix E; NQMC Glossary |
13 | RELIABILITY | Measure reliability: The results of the measure are reproducible a high proportion of the time when assessed in the same population (e.g., the measure has high inter-rater reliability, no calculation errors). Internal consistency reliability (http://en.wikipedia.org/wiki/Internal_consistency ![]() Inter-rater reliability (http://en.wikipedia.org/wiki/Inter-rater_reliability ![]() Test-retest (http://en.wikipedia.org/wiki/Test-retest_reliability ![]() ![]() ![]() | CMS; Wikipedia based on The Standards for Educational and Psychological Testing, 1999a; The Free Dictionary by Farlex |
14 | STRUCTURE | Structure refers traditionally to the attributes of settings in which providers deliver health care, including material resources (e.g., electronic health records), human resources (e.g., staff expertise), and organizational structure (adapted from IOM, Performance Measurement, 2006; Appendix E). Some have suggested that structural attributes should include organizational characteristics such as leadership and culture (Kunkel, 2007) and system attributes beyond individual health care delivery settings. | Adapted from IOM, 2006, Appendix E |
15 | STRUCTURAL MEASURE | Measures of structure assess the capacity of health care professionals and organizations to provide safe, timely, effective, equitable, efficient and patient-centered processes of care and positive health outcomes. | Adapted from AHRQ |
16 | STRUCTURE-PROCESS-OUTCOMES MODEL | As identified by Donabedian (1988), the classic paradigm for assessing quality of care based on a three-component approach. Donabedian's model proposes that each component has a direct influence on the next, as represented by the arrows in this schematic (Donabedian, 1980): Structure influences Process, which in turn influences Outcomes. | IOM, 2006, Appendix E |
17 | VALIDITY | Measure accurately represents the concept being evaluated and achieves the purpose for which it is intended (to measure quality). In science (http://en.wikipedia.org/wiki/Science ![]() ![]() Concurrent validity (http://en.wikipedia.org/wiki/Concurrent_validity ![]() Construct validity is the extent to which a measure measures the concept or construct that it is intended to measure. For example, a measure that measures the quality of diabetes care by whether a provider conducted an HbA1c test on a patient with diabetes has relatively good construct validity because high HbA1c levels are associated with diabetes crises. Content validity. In psychometrics (http://en.wikipedia.org/wiki/Psychometrics">psychometric ![]() ![]() Criterion validity (http://en.wikipedia.org/wiki/Criterion_validity ![]() Face validity is the validity of a measure at face value. Generally face validity means that the measure "looks like" it will work, as opposed to "has been shown to work." Predictive validity (http://en.wikipedia.org/wiki/Predictive_validity ![]() Measures should be assessed against all relevant criteria at all intended levels of aggregation. | CMS, Wikipedia, based on The Standards for Educational and Psychological Testing, 1999a |
a. A revised version is expected after 2012.