How can Health Care Organizations be Reliably Compared?

• DOI: 10.1097/mlr.0b013e31821b3482
• Publication Date: 2011-05-26T07:54:56Z
• Authors: Georgios Lyratzop...; Marc N. Elliott; Josephine M. Barb...; Laura Staetsky; Charlotte A. Padd...; John Campbell; Martin Roland
• Keywords: Male; Primary Health Care; Quality Assurance, Health Care; Communication; Reproducibility of Results; Continuity of Patient Care; Health Services Accessibility; Patient Care Planning; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Patient Satisfaction; Surveys and Questionnaires; Humans; Female; Health Services Research; Quality Indicators, Health Care

Patient experience is increasingly used to assess organizational performance, for example in public reporting or pay-for-performance schemes. Conventional approaches using 95% confidence intervals are commonly determine required survey samples report performance but these may result unreliable comparisons.We analyzed data from 2.2 million patients who responded the English 2009 General Practice Survey, which included 45 patient questions nested within 6 different care domains (access, continuity of care, communication, anticipatory planning, out-of-hours and overall satisfaction). For each question, unadjusted case-mix adjusted (for age, sex, ethnicity) organization-level reliability, intraclass correlation coefficients were calculated.Mean responses per organization ranged 23 256 evaluating primary practices, 1454 2758 organizations. Adjusted reliability values similar. Twenty-six had excellent (≥0.90). Seven nurse communication very good (≥0.85), 3 planning lower (<0.70). Reliability was typically <0.70 with <100 mean practice, usually indicating only a subset eligible answer. Nine both high (≥0.10) reliable measurement substantial variability.High necessary property indicators compare health Using Survey as case study, we show how can be select measures support robust comparisons, design surveys that will provide high-quality optimize costs.