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Medical Care Research and Review
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*Epilepsy
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What's this?

Improving Methods for Measuring Quality of Care

A Patient-Centered Approach in Chronic Disease

Barbara G. Bokhour

Edith Nourse Rogers Memorial Veterans Affairs Medical Center, Bedford, MA, Boston University School of Public Health, Boston

Mary Jo Pugh

South Texas Veterans Health Care System, Veterans Evidence-Based Research Dissemination Implementation Center Research Enhancement Award Program, San Antonio, University of Texas Health Science Center at San Antonio

Jaya K. Rao

Healthy Aging Program, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, Emory University School of Medicine, Atlanta, GA

Ruzan Avetisyan

Boston University School of Public Health, Boston

Dan R. Berlowitz

Center for Health, Quality, Outcomes & Economic Research, Edith Nourse Rogers Memorial Veterans Affairs Medical Center, Bedford, MA, Boston University School of Public Health, Boston

Lewis E. Kazis

Center for Health, Quality, Outcomes & Economic Research, Edith Nourse Rogers Memorial Veterans Affairs Medical Center, Bedford, MA, Boston University School of Public Health, Boston

As health care systems seek to provide patient-centered care as a cornerstone of quality, how to measure this aspect of quality has become a concern. Previous development of quality indicators for treating individual chronic disease has rarely included patient perspectives on quality of care. Using epilepsy as an exemplar, the authors sought to develop an approach to measuring patient-centered quality of care. They conducted six focus groups with adults with epilepsy. Using qualitative methods, the authors initially identified 10 patient-generated quality indicators, 5 of which were subsequently rated, along with literature-based quality indicators, by an expert panel using a modified RAND appropriateness methodology. The authors discuss similarities and differences in aspects of care patients and providers value as essential for good quality. The process presented in this article may serve as a model for incorporating patient perceptions of quality into the future development of quality indicators for chronic diseases.

Key Words: quality indicators • patient-centered care • chronic disease • epilepsy • qualitative methods

This version was published on April 1, 2009

Medical Care Research and Review, Vol. 66, No. 2, 147-166 (2009)
DOI: 10.1177/1077558708327174
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