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Measuring Performance in Primary Care: What Patient Outcome Indicators Do Physicians Value?

From the Department of Family and Community Medicine, University of Kentucky, Lexington, KY

Correspondence: Corresponding author: Paul Dassow, MD, MSPH, Department of Family and Community Medicine, University of Kentucky, K-307, Kentucky Clinic, Lexington KY 40536 (E-mail: pdass1{at}email.uky.edu)

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 (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.