Importance of the Quality Characteristic Captured with the Quality Indicator for Patients and the Health Care System

There is a consensus in the literature that this criterion is a basic requirement for the meaningful use of quality indicators (e.g. McGlynn 2003, AWMF and AZQ 2001, JCAHO 2006).

A weighing of the respective arguments (large number of cases, high costs, …) for the meaning of an indicator, was abandoned, since there is no scientific information basis for it. Instead, all arguments should be included in the assessment with consideration of the personal expertise of the evaluators. In the case of a positive assessment at least one argument must be fulfilled.

Definition
The indicator captures essential aspects of quality of life, morbidity and/or mortality. The importance of the indicator can for example be justified through:

• The frequency and/or severity level of an unwanted event (high risk)
• A high case number in the observed health care area
• High costs
• A known or assumed high variability of care
• An overall low standard of care
• A change in health care or guidelines
• A change of the general framework, (e.g. reimbursement, health care centers, disease management programs) with potentially false incentives for the care
• The agreement with national / regional goals for quality of the health care system or
• A high public interest, especially from patients

Core Statement
The following statement is assessed: “The indicator captures essential aspects of the quality of life, morbidity or mortality.”

Information Base for the Assessment
For the assessment of the core statement as much relevant information as possible should be compiled. Sources of information include for example: data from measurement activities (e.g. performance measurement by BQS), data from registries, epidemiological data from health reporting, administrative routine data, statistics (e.g. cause of death statistics) and national and international publications. Furthermore, the evaluators can contribute information from their areas of expertise (e.g. quality circles, self-help organizations).

Assessment Process
After all evaluators have acknowledged and understood the information base, they assess the core statement.

A detailed process description can be found in Appendix 1.

Assessment stages
1 = does not apply
2 = rather does not apply
3 = rather applies
4 = applies
Abstention