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December NaN, 2014

Quality Measures and Sociodemographic Risk FactorsTo Adjust or Not to Adjust

Author Affiliations
  • 1Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
  • 2Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York
  • 3National Quality Forum, Washington, DC
  • 4Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan
JAMA. 2014;312(24):2615-2616. doi:10.1001/jama.2014.15372

In 2006, the National Quality Forum (NQF) established a policy against adjusting quality measures for sociodemographic risk factors, ie, socioeconomic status and other social risk factors.1 This policy was based on concern that statistical adjustment could mask poor care provided to socially disadvantaged patients and create lower standards of care. However, given the potential influence of sociodemographic risk on health and health care, this policy of not including risk adjustment, adopted by the Centers for Medicare & Medicaid Services (CMS) and others, potentially results in unfair comparisons among clinicians, hospitals, and other health care organizations.2

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