Developing a Reliable, Valid, and Feasible Plan for Quality-of-Care Measurement for Cancer

Background. Recent changes in the US health care delivery system have raised expectations that the medical marketplace will compete on quality and cost of care. This effort will require a systematic evaluation of the measurement of quality of care as it applies to cancer and other critical conditions. Objectives. To articulate the components of the design of quality-of-care measurement systems that must be considered and optimally manipulated to generate feasible, reliable, and valid data pertinent to patients with cancer. Research Design. A synthesis of information obtained from literature reviews and experience. Measures. Four key areas of design that influence quality-of-care measurement scores are discussed: case identification, data source, data-collection strategies, and the quality of the care-measurement model. Results. Challenges associated with these design and measurement strategies are defined and discussed. Conclusions. Policy analyses vary as a function of measurement domains. The design of a quality-of-care measurement system should consider trade-offs between validity and burden by considering the intricate relations between domains of measurement.