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through various types of performance measurement (Table 1), including process, outcome, patient

experience, structural, and composite measures (NQF, The ABCs of Measurement, 2022). Process

measures capture recommendations from clinical guidelines, demonstrating the steps a clinical provider

follows to maintain or improve health among their patient populations. Outcome measures reflect the

health effect of a service or treatment, but also take into account factors and variables beyond

providers’ control using risk adjustment. Patient experience measures capture personal perspectives

about care received within the healthcare delivery system. Structural measures inform healthcare

consumers about health systems and providers capacity, resources, and processes for quality

healthcare. Finally, composite measures provide a comprehensive view of care by combining the results

of multiple measures. Together, measure types provide a picture of healthcare quality for a given

organization or clinician.

Table 1. Types of Quality Measures

Quality Measure by Type

Description

Process

Measures if an action or process step was completed or not — examples percent of people receiving mammograms or immunizations, or percent of patients who had blood sugar tested and controlled for diabetes.

Outcome

Measures the actual results of clinical care.

Patient Experience

Record patients’ perspectives on their care.

Structural

Measures the conditions in which providers care for patients, such as staffing and the volume of procedures performed by a provider. Combines the result of multiple measures to provide a more comprehensive picture of quality care.

Composite

Other Quality Measures Balancing Measures

Systems level measures that look at if changes in one part of the system cause problems in other

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