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Adeline J. Wilcox

Retired



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253 – SPEED: Government Statistics, Health Policy, and Marketing

Beneath the Veneer of Healthcare Quality Measurement

Sponsor: Government Statistics Section
Keywords: sample size, estimation, healthcare, quality measurement

Adeline J. Wilcox

Retired

Under contract to the Centers for Medicare & Medicaid Services, The Joint Commission specifies sample sizes for healthcare quality measurement. Their sample size specifications do not follow established methodology for sample size estimation. Sample sizes for estimates are specified without explanation or calculations for precision. A recent visioning publication of the National Academy of Medicine (NAM) makes clear that the analytical objectives of healthcare quality measurement remain to be determined. The NAM authors use the term reliability without addressing either precision or sample size. Healthcare quality measurement is a form of self-regulation by the medical profession. Physicians control healthcare quality measurement. Organized statisticians have no no apparent role. Until January 2017, the Office of Management and Budget (OMB) required the principal statistical agencies to plan the precision of their estimates. However, OMB did not apply their requirements to healthcare quality measurement. Physicians expect to practice free from outside scrutiny.

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