Hospital quality indicators are not unidimensional: A reanalysis of Lieberthal and Comer. (26th September 2018)

• Record Type: Journal Article
• Authors: Cefalu, Matthew S.; Elliott, Marc N.; Setodji, Claude M.; Cleary, Paul D.; Hays, Ron D.
• Is Part Of: Health services research. Volume 54:Number 2(2019)
• Page Start: 502
• Page End: 508
• Publication Date: 2018-09-26
• Subjects: hospitals -- patient experience -- Quality of care/patient safety (measurement); Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.13056
• Languages: English
• ISSNs: 0017-9124

Abstract

Abstract : Objective: To evaluate the dimensionality of hospital quality indicators treated as unidimensional in a prior publication. Data Source/Study Design: Pooled cross‐sectional 2010‐2011 Hospital Compare data (10/1/10 and 10/1/11 archives) and the 2012 American Hospital Association Annual Survey. Data Extraction: We used 71 indicators of structure, process, and outcomes of hospital care in a principal component analysis of Ridit scores to evaluate the dimensionality of the indicators. We conducted an exploratory factor analysis using only the indicators in the Centers for Medicare & Medicaid Services' Hospital Value‐Based Purchasing. Principal Findings: There were four underlying dimensions of hospital quality: patient experience, mortality, and two clinical process dimensions. Conclusions: Hospital quality should be measured using a variety of indicators reflecting different dimensions of quality. Treating hospital quality as unidimensional leads to erroneous conclusions about the performance of different hospitals.