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- W2340938161 abstract "### Key messagesEfforts to improve quality of care in hospitals often start by comparing clinical processes between hospitals. However, earlier studies have suggested that better performance in process measures believed to be clinically meaningful may not always be linked to improved patient outcomes. At times, this unexpected finding has led to enormous confusion between quality experts and clinicians. In this issue, Bruckel et al 1 use data on patients with acute myocardial infarction to tackle a potentially key aspect of this paradox by focusing on the ‘denominator problem’—the observation that large numbers of patient exclusions from many process measures may erode the ability to judge hospitals on the quality of care delivered.Some allowance for exclusions is widely seen as necessary to ensure enough homogeneity in patients to allow for meaningful comparisons between hospitals. However, the use of exclusions …" @default.
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- W2340938161 date "2016-04-19" @default.
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- W2340938161 title "Exclusions in the denominators of process-based quality measures: the missing link in understanding performance or ecological fallacy?" @default.
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- W2340938161 doi "https://doi.org/10.1136/bmjqs-2016-005254" @default.
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