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February 25, 2008

Measuring the Performance of Performance Measurement

Arch Intern Med. 2008;168(4):347-348. doi:10.1001/archinternmed.2007.81

It is well-known that the medical care provided to patients often is not of the highest quality. Undisputed life-saving therapies, such as influenza vaccination for elderly patients or β-blockers for patients with an acute myocardial infarction, may not be given. This recognition has prompted ever-increasing efforts by governmental agencies, payers, and health care consumer groups to spur physicians and health care organizations to improve the quality of medical care.

The Centers for Medicare & Medicaid Services (CMS) has been at the forefront of these efforts via a multipronged quality improvement program. Among other interventions, CMS has overseen a program involving auditing and reporting the rate of performance of several recommended processes of care in hospitalized patients. These processes have generally been derived from practice guidelines produced by specialty medical societies. Seeking to get the most “bang for the buck,” CMS has concentrated on common conditions that result in significant morbidity and mortality, such as heart failure, myocardial infarction, and pneumonia.

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