TY - JOUR
T1 - Mitigating the problem of unmeasured outcomes in quality reports
AU - Glazer, Jacob
AU - McGuire, Thomas
AU - Normand, Sharon Lise T.
N1 - Funding Information:
∗This research was supported by research grants from the National Institute of Mental Health (R34 MH071242), the Agency for Healthcare Research and Quality (P01 HS10803) and the Program in Health Systems Improvement at Harvard University. Paul Cleary, Richard Frank, Joseph New-house, Will White and Alan Zaslavsky provided helpful comments on an earlier draft. The authors thank Ting Liu, Treacy Silverstein, and Jaiyin Sun for able research assistance. Special thanks are due to Don Fullerton and two anonymous referees for excellent comments and suggestions on an earlier draft of this paper.
PY - 2008
Y1 - 2008
N2 - Quality reports or profiles of health care providers are inevitably based on only a measurable subset of the "outputs" of the organization. Hospitals, for example, are being profiled on their mortality in the cardiac area but not in some other areas where mortality does not seem to be the appropriate measure of quality. If inputs used for outputs included in the profile also affect outputs outside the scope of the profile, it can be taken into account in constructing a profile of the measured outputs. This paper presents a theory for how such a commonality in production should be taken into account in designing a profile for a hospital or other health care provider. We distinguish between "conventional" weights in a quality profile, and "optimal" weights that take into account a commonality in the production process. The basic idea is to increase the weights on discharges for which output is measured that use inputs that are important to other discharges whose outputs are not included in the profile.
AB - Quality reports or profiles of health care providers are inevitably based on only a measurable subset of the "outputs" of the organization. Hospitals, for example, are being profiled on their mortality in the cardiac area but not in some other areas where mortality does not seem to be the appropriate measure of quality. If inputs used for outputs included in the profile also affect outputs outside the scope of the profile, it can be taken into account in constructing a profile of the measured outputs. This paper presents a theory for how such a commonality in production should be taken into account in designing a profile for a hospital or other health care provider. We distinguish between "conventional" weights in a quality profile, and "optimal" weights that take into account a commonality in the production process. The basic idea is to increase the weights on discharges for which output is measured that use inputs that are important to other discharges whose outputs are not included in the profile.
KW - Hospitals
KW - Partial reports
KW - Quality reports
UR - http://www.scopus.com/inward/record.url?scp=48749118800&partnerID=8YFLogxK
U2 - 10.2202/1935-1682.1738
DO - 10.2202/1935-1682.1738
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C2 - 20490360
AN - SCOPUS:48749118800
SN - 1538-0653
VL - 8
JO - B.E. Journal of Economic Analysis and Policy
JF - B.E. Journal of Economic Analysis and Policy
IS - 2
M1 - 7
ER -