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Essential Criterion. Measures must meet this criterion to be rated on the desirable criteria that are listed below.

    1. Objectively based on substantial research. The specific activity or intervention addressed by the measure must have a body of research showing effectiveness. The submitting organization should briefly describe the findings and give several key references.

Desirable Criteria. Measures are rated (“high,” “medium,” or “low”) based on the following criteria.

    2. Relevance. The measure should address features of health care systems that are relevant to the target audience of policy makers, health professionals, and consumers.

    • Meaningfulness. The measure should be meaningful to at least one of the audiences. Decision makers should be able to understand the clinical and economic significance of differences in how well systems perform on the measure. The meaningfulness of a measure is enhanced if benchmarks and targets are available.

    • Health importance. The measure should capture as much of the health care system's activities relating to quality as possible. Factors to be considered in evaluating the health importance of a measure include the type of measure (e.g., outcome versus process), the prevalence of the medical conditions to which the measure applies, and the seriousness of the health outcomes affected.

    • Strategic importance. The measure should encourage activities that deserve high priority in terms of using resources most efficiently to maximize the health of their members. In general, measures that are of high clinical importance, of high financial importance, and cost-effective will also have high priority.

    • Controllability. There should be actions that health care systems can take to improve their performance on a measure. If the measure is an outcome measure, there should exist one or more processes that can be controlled by the system that have important effects on the outcome. If the measure is a process measure, the process should be substantially under the control of the system, and there should be a strong link between the process and desired outcomes. If the measure is a structural measure, the structural feature should be open to modification by the system, and there should be a strong link between the structure and desired outcomes. The measure's time period should capture the events that have impact on clinical outcomes and reflect the time horizon over which the health care system had control.

    • Timeliness. The data must be sufficiently current to be relevant to the audience. Submitting organization must give time from event to available data.

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