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Comparative health care information: consumer quality index (CQI) information on differences between providers.

Damman, O.C., Stubbe, J.H., Triemstra, A.H.M., Spreeuwenberg, P., Delnoij, D.M.J. Comparative health care information: consumer quality index (CQI) information on differences between providers. European Journal of Public Health: 2007, 17(suppl. 2), p. 34. Abstract. 15th Annual EUPHA Meeting: "The future of public health in the Unified Europe", Helsinki, 11-13 oktober 2007.
Background: Public reporting on health care performances has become an important quality-improvement instrument. In the Netherlands, consumer quality index (CQI) questionnaires are currently being used to assess patients’ experiences with various domains of the health care system. An important question is whether CQI questionnaires are able to measure differences between health care providers, so called discriminative power. Methods: Two CQI questionnaires were tested on their discriminative power by multilevel regression analyses: the CQI hip and knee surgery and the CQI nursing homes and home care. 1,508 respondents from 43 hospitals filled in the CQI hip and knee surgery, and 2,386 clients from 92 nursing homes and 1,363 clients from 19 home care providers filled in the CQI nursing homes and home care. Intra-class correlations (ICC) were calculated to evaluate whether patients’ experiences depend partly on the hospital or organization in which they were treated. Results: Multilevel analyses showed that health care providers account for part of the variance in patients’ experiences with quality of care. However, some outcome variables did not differ significantly between providers. The ICCs varied from 0.00 to 0.04 for different quality aspects in the CQI hip and knee surgery. When the CQI nursing homes and home care was concerned, the ICCs ranged from 0.04 to 0.38 on quality aspects of nursing homes, and from 0.00 to 0.13 on quality aspects of home care providers. Conclusions: Use of CQI instruments allows comparisons between health care providers on several dimensions of quality of health care seen from patients’ perspective. Discriminative qualities differ across distinct domains of health care. Furthermore, discriminative qualities vary across quality aspects within these domains which indicates heterogeneity of quality differences across the health care system. (aut. ref.)