Multistakeholder Perspectives on Composite Measures of Ambulatory Care Quality

A Qualitative Descriptive Study

To improve quality of health care, reduce costs, or improve access, multiple stakeholders use various quality measures from different sources.

Composite measures, which combine two or more quality measures or indicators into one measure and result in a single score, offer a way to make quality data more useful to an array of stakeholders.

In an effort to better understand the views of different stakeholders relative to composite measures of ambulatory care quality, researchers conducted 29 semi-structured opinion interviews from “on-the-ground” practitioners. Survey participants were chosen to represent consumers, payers, purchasers, and providers from the Puget Sound Health Alliance, a multistakeholder collaborative organization in the greater Seattle area. The authors developed a series of research questions to guide their interviews.

Key Points:

  • 75 percent surveyed thought composite measures were useful for consumers (as opposed to health plans or employers).
  • 40 percent were concerned that composite measures would “hide” information contained in individual indicators.
  • Few respondents (less than 25%) had experience with composite calculation techniques and half would defer to experts, provided there was assurance that “due diligence” was conducted.
  • Many said that composite development techniques need to be transparent (66%); some wanted measures subject to a stringent vetting process (33%).