Table 2.

Description of Patient-Rated and Condition-Specific Outcomes

Measure and ScaleDescription
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