Examples of Physician Quality Measures for Consumers

Following are a few examples of physician quality measures that research evidence and practical experience suggest are appropriate for reporting to consumers. The list is categorized by the Institute of Medicine’s domains for a quality health care system; for definitions, go to The Six Domains of Health Care Quality.

Researchers have found that consumers are interested in quality measures that convey information about a physician’s technical care as well as interpersonal skill. Typically, technical quality is measured using clinical information found in administrative databases, electronic health records, or medical charts, whereas interpersonal quality is measured using patient surveys. The findings suggest that sponsors of physician report cards should include measures of both technical and interpersonal quality to create report cards that are most useful to patients.¹

Patient Safety Measures:

• Screening, risk-assessment, and plan of care to prevent future falls in older adults.
• Screening for osteoporosis for women 65–85 years of age.
• Avoidance of antibiotic treatment in adults with acute bronchitis.

Effectiveness Measures:

• Percentage of patients receiving recommended care or treatment for various conditions, including respiratory disease, bone and joint conditions, diabetes, heart disease, mental health, and substance abuse.
• Percentage of patients receiving recommended preventive care and screening services for health concerns, such as cancer, obesity, and smoking cessation.

Patient-Centeredness Measures:

• Patients' reports on the care and service they received from their physicians.
• Education and counseling for patients with certain conditions (e.g., hepatitis, heart failure).

Timeliness Measures:

• Patients' reports on the timeliness of care and service they received from their physicians.
• Percentage of surgical patients who received certain medications (e.g., antibiotics, beta blockers) within a certain time period prior to surgery.

Efficiency Measures:

• Appropriate use of imaging studies for low back pain.
• Appropriate use of DXA scans in women under 65 years who do not meet the risk factor profile for osteoporotic fracture.
• Percentage of all cardiac stress imaging performed for initial detection and risk assessment in patients who are asymptomatic and at low risk for coronary heart disease.

Descriptive Measures: While not associated with any particular IOM domain, descriptive measures can convey the physician's capacity for providing quality of care and service. Examples include:

• The use of electronic patient medical records, personal health records, or prescription ordering systems.
• Percentage of physicians who are board-certified and who maintained their certification.
• The number of surgical procedures (e.g., hip replacement, carotid endarterectomy) a physician performed. This type of measure—referred to as volume--is considered a proxy for quality. However, with the exception of a few high-risk procedures, researchers have not yet determined the exact relationship between volume and good patient care.

Reference

1. Fung CH, Elliott MN, Hays RD, Kahn KL, Kanouse DE, McGlynn EA, Spranca MD, Shekelle PG. Patients' preferences for technical versus interpersonal quality when selecting a primary care physician. Health Services Research 2005. (40): 957-977.

Also in "Measures of Physician Quality"

• Examples of Physician Measures for Consumers
• Major Physician Measurement Sets