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In April, the Portland, OR-based Foundation for Accountability (FACCT) released a new patient-centered data set aimed at measuring outcomes for asthma.
The measurement set includes patient self-reports covering four general areas: quality of life, clinical outcome, satisfaction, and essential care. Quality-of-life measurements include the following:
• physical function;
• physical role performance;
• bodily pain;
• general health;
• social function;
• emotional role performance;
• mental health.
Satisfaction includes questionnaires for technical quality of care and access to care, while essential care processes include measurement tools for lung function, asthma care plan, avoidance of environmental irritants, and education. The clinical outcomes measures (hospitalization rate and emergency department rate) rely primarily on billing data. (See chart outlining the asthma measures, p. 68.)
In compiling a measurement set for a given disease state, FACCT starts by conducting preliminary surveys and focus groups of health care consumers, asking them what they consider most important about the condition. The foundation also commissions a scientific paper to review the literature on the condition and to evaluate existing quality measures, says Dunn. "We also ask them to make some suggestions as to what FACCT should be collecting in our framework for what we want to accomplish," she says.
FACCT then writes draft measures, with the help of a small advisory group of academicians and researchers. The foundation follows up by convening a national meeting of scientists to discuss the draft measures and suggest any changes. After undergoing public review, the draft measures must be approved by FACCT’s measures council. Finally, the measures are voted on by the foundation’s board of trustees, which includes many of the country’s largest employers, such as AT&T, and large organizations representing consumers such as the American Association of Retired Persons and the American Federation of Labor and Congress of Industrial Organizations.