Description of Patient-Rated and Condition-Specific Outcomes
| Measure and Scale | Description |
|---|---|
| ACES = Ambulatory Care Experiences Survey; ACES-SF = Ambulatory Care Experiences Survey–Short Form; ACGME = American Council for Graduate Medical Education; ACQA = Ambulatory Care Quality Alliance; CARE = consultation and relational empathy; CPCI = Components of Primary Care Index; HbA1c=hemoglobin A1c; LDL=low-density lipoprotein; N/A=not applicable; PEI=Patient Enablement Index. | |
| a Data collected by self-administered patient questionnaires. | |
| b Data collected by medical record audits. | |
| Patient-rated outcomesa | |
| Access to first-contact care (ACES; range, 0–1.0) | Help as soon as needed for an illness or injury; appointment for a checkup or routine care as soon as needed; answer to medical question the same day when calling during regular office hours; help or advice needed when calling after regular office hours |
| Coordination of care (CPCI; range, 0–1.0) | Keeps track of all my health care; follows up on a problem I’ve had, either at the next visit or by mail, e-mail, or telephone; follows up on my visit to other health care professionals; helps me interpret my laboratory tests, x-rays, or visits to other doctors; communicates with other health professionals I see |
| Comprehensive care (CPCI; range, 0–1.0) | Handles emergencies; care of almost any medical problem I may have; go for help with a personal or medical problem; go for care for an ongoing medical problem such as high blood pressure; go for a checkup to prevent illness |
| Personal relationship over time (CPCI; range, 0–1.0) | Knows a lot about my family medical history; have been through a lot together; understands what is important to me regarding my health; knows my medical history very well; takes my beliefs and wishes into account in caring for me; knows whether or not I exercise, eat right, smoke, or drink alcohol; knows me well as a person (such as hobbies, job, etc) |
| Global practice experience (range, 0–1.0) (all or none) | Strongly agree with: “I receive the care I want and need when and how I want and need it,” and strongly agree with: “I am delighted with this practice.” |
| Self-reported health status (range, 1–5) | In general how would you rate your overall health status? (excellent, very good, good, fair, poor) |
| Patient empowerment (range, 0–2.0) | Patient enablement (PEI; range, 0–1.0): In relation to your most recent visit, are you: able to cope with life; able to understand your illness; able to cope with your illness; able to keep yourself healthy; confident about your health; able to help yourself? (response options for each: much better, better, same or less, N/A) |
| Consultation and relational empathy measure (CARE; range, 0–1.0): For your last doctor’s visit, how was the doctor at: making you feel at ease; letting you tell your “story”; really listening; being interested in you as a whole person; fully understanding your concerns; showing care and compassion; being positive; explaining things clearly; helping you take control; and making a plan of action with you? (response options for each: excellent, very good, good, fair, poor, N/A) | |
| Satisfaction with service relationship (range, 0–3.0) | Physician satisfaction (ACES-SF; range, 0–2.0): rating of personal physician (0 = worst, 10 = best); recommend personal physician to family and friends (5 = definitely yes, 1=definitely not) |
| Cultural responsiveness (ACGME; range, 0–1.0): the practice looks down on me and the way I live my life; the practice treats me with respect and dignity; the practice would provide better care if I were of a different race (for each, 5 = strongly agree, 1 = strongly disagree) | |
| Condition-specific outcomesb | |
| ACQA Starter Set measure (16 measures) | 7 prevention measures: breast cancer screening, colon cancer screening, cervical cancer screening, tobacco use history, advice for smoking cessation, seasonal influenza vaccination, and pneumonia vaccination |
| 2 coronary artery disease measures: prescription of lipid-lowering medications, prescription of aspirin prophylaxis | |
| 6 diabetes measures: HbA1c measurement, HbA1c under control, blood pressure at target, lipid measurement, LDL cholesterol at target, retinal examination up to date | |
| 1 acute care measure: appropriate use of antibiotics in children for upper respiratory tract infections | |
| Prevention score (percentage of eligible patients meeting recommendations) | US Preventive Services Task Force recommendations by age and sex as of July 2006 |
| Chronic disease care score (range, 0–1.0) | Percentage of patients having a diagnosis of diabetes, hypertension, coronary artery disease, and hyperlipidemia receiving recommended treatments and assessments |
| 8 diabetes measures: LDL cholesterol measured in previous year, LDL cholesterol <100 mg/dL, retinal examination by eye professional in previous year, HbA1c measured in the previous year, HbA1c <9%, last blood pressure <130/80 mm Hg, foot examination in the previous year, aspirin prophylaxis | |
| 2 hypertension measures: blood pressure at target (<140/90 mm Hg if nondiabetic, <130/80 mm Hg if diabetic), on aspirin prophylaxis | |
| 3 coronary artery disease measures: blood pressure at target, aspirin prophylaxis, on lipid-lowering therapy | |
| 4 hyperlipidemia measures: on lipid-lowering therapy, LDL at target (<100 mg/dL for diabetic patients and <130 mg/dL for nondiabetic patients), blood pressure at target, on aspirin prophylaxis | |