Measuring performance in primary care: what patient outcome indicators do physicians value?

Abstract

BACKGROUND: Determining which patient outcome indicators may be appropriate to include in a primary care, practice performance tool is a difficult task. Unfortunately, no published studies currently document the opinions of these physicians regarding which indicators they most value. OBJECTIVE: To ascertain the level of agreement among primary care physicians regarding the most salient patient outcome indicators for measuring performance in primary care. METHODS: A random population survey of 115 adult primary care physicians. The survey consisted of a comprehensive list of health characteristics included in 8 validated instruments (eg, SF-36, Sickness Impact Profile), as well as 10 common clinical indicators and 6 health behaviors. Each item was ranked using a 5-point Likert scale regarding its value for inclusion in a performance measure. RESULTS: Analysis of 93 returned surveys (RR 81%) indicated strong agreement (> or = 75%) that 19 health characteristics were important or very important. These characteristics fit into 8 domains: physical functioning, psychological functioning, social functioning, pain, quality of life, physiologic symptoms, health behaviors, and clinical indicators. Notably absent were measures of social support and health perceptions. CONCLUSIONS: Strong agreement exists among practicing primary care physicians regarding the most valued patient outcome indicators. Development of practice performance measures should be influenced by such data.