The IOM 2001 Recommendations for Measure Selection Criteria for the NHQR and NHDR
In the IOM’s 2001 report Envisioning the National Healthcare Quality Report, three major criteria were proposed for measure selection:
The 2001 IOM report stipulated that it is desirable for a measure to meet all 10 elements within the three overall criteria, but noted that it is not required that all 10 apply in order for a given measure to be considered for inclusion in the NHQR and NHDR.
The 2001 IOM committee indicated that the three criteria, as listed above, provide a hierarchy by which measures should be considered, with priority to be given to measures evaluated for importance and scientific soundness and then by feasibility. For example, the committee stated:
Measures that address important areas and are scientifically sound, but are not feasible in the immediate future, deserve potential inclusion in the data set and further consideration. However, measures that are scientifically sound and feasible, but do not address an important problem area, would not qualify for the report regardless of the degree of feasibility or scientific soundness.
SOURCE: IOM, 2001, pp.83 and 87.
chosen for Healthy People 2010 (cancer, diabetes, end-stage renal disease, heart disease, HIV/AIDS, maternal and child health, mental health, respiratory disease, and nursing home and home health care) (AHRQ, 2003a; HHS, 2009b).
AHRQ reduced the number of measures presented in subsequent editions in response to criticisms that the first edition was unwieldy (Gold and Nyman, 2004). The intent was to be able to “highlight measures with in-depth analysis, rather than broad, but sparse, coverage of all 179 measures” (AHRQ, 2004).2 That basic format is maintained by AHRQ today, with a set of approximately 46 core measures presented in the body of the reports and more detailed tables available online for a larger set of measures. To select the 46 core measures for the NHQR and NHDR, AHRQ staff and the HHS Interagency Workgroup prioritized measures by the three original IOM criteria and several additional ones. Usability was added as a new primary criterion—one that is also articulated