Watkins Katherine, Horvitz-Lennon Marcela, Caldarone Leah Barnes, Shugarman Lisa R, Smith Brad, Mannle Thomas E, Kivlahan Daniel R, Pincus Harold Alan
University of Pennsylvania, USA.
J Healthc Qual. 2011 Jan-Feb;33(1):49-66; quiz 66-7. doi: 10.1111/j.1945-1474.2010.00128.x.
Recent attention has focused on validity and feasibility of different approaches to developing performance indicators for the purposes of quality improvement and value-based purchasing. This paper presents the methodology used to develop a comprehensive set of performance indicators that will be used for a national evaluation of the mental healthcare provided by the Veterans Health Administration. The paper report on the indicators' technical specifications and the United States Public Health System Task Force defined strength of supporting evidence. Indicators were reviewed iteratively for meaningfulness, utility, feasibility, and supporting evidence until a final set of measures of acceptable validity and feasibility was produced with technical specifications. Fifty-seven mental health performance indicators that use information from both the medical record and administrative data (hybrid indicators) and 31 administrative-data only indicators are presented. Of the 57 hybrid indicators, 13 indicators are supported by Agency for Healthcare Research and Quality grade I evidence, 5 indicators are grade II, and 39 indicators are grade III. This paper describes the methodology used to develop 88 performance indicators of the quality of mental health and substance abuse treatment, and presents the technical specifications associated with each indicator.
近期，人们的注意力集中在为质量改进和基于价值的采购制定绩效指标的不同方法的有效性和可行性上。本文介绍了用于制定一套全面绩效指标的方法，该指标将用于对退伍军人健康管理局提供的精神卫生保健进行全国性评估。本文报告了指标的技术规范以及美国公共卫生系统特别工作组定义的支持证据的力度。对指标进行反复审查，以确保其意义、实用性、可行性和支持证据，直到最终产生一套具有可接受有效性和可行性且具备技术规范的指标。本文介绍了57项使用病历和行政数据信息的精神卫生绩效指标（混合指标）以及31项仅使用行政数据的指标。在57项混合指标中，13项指标得到了医疗保健研究与质量局一级证据的支持，5项为二级指标，39项为三级指标。本文描述了用于制定88项精神卫生和药物滥用治疗质量绩效指标的方法，并介绍了与每个指标相关的技术规范。
