Should We Adjust Quality Measures for Patient Socioeconomic Status?
*Alan M Zaslavsky, Harvard Medical School
Keywords: quality, disparities, socioeconomic effects
Adjustment of quality measures for clinical risk factors is noncontroversial. Despite its formal similarity, adjustment for socioeconomic factors has met strong objections on grounds of principle ("adjustment masks disparities"), practicality (too hard to get the required data), and importance (adjustments are minor). I will argue that adjustment is justified on principle and does not mask disparities, data for such adjustment is at least sometimes available, and adjustments can be of practical significance. Finally, I consider some policy implications of choosing to adjust or not.