Patient Outcome Measurement Flashcards

Which international classification system is most commonly used to define and code patient diagnoses and outcomes for administrative data analysis?

Answer: ICD-10-CM

ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is the US standard for coding diagnoses and is used in claims and administrative outcome data.

A provider organization wants to measure whether patients achieve their self-defined health goals after treatment. Which approach best captures this?

Answer: Goal attainment scaling (GAS)

Goal attainment scaling individualizes outcome measurement by rating progress toward specific patient-defined goals on a standardized numerical scale.

Which measure type quantifies the additional cost required to gain one quality-adjusted life year (QALY) through a healthcare intervention?

Answer: Incremental cost-effectiveness ratio (ICER)

The ICER divides the difference in costs between two interventions by the difference in QALYs gained, providing a cost-per-QALY benchmark for value assessment.

In patient outcome analytics, what does 'observed-to-expected (O/E) ratio' indicate when it is greater than 1.0?

Answer: Worse-than-expected outcomes after risk adjustment

An O/E ratio above 1.0 means a hospital's observed adverse outcomes exceed the number expected based on its patient risk profile, signaling potentially suboptimal performance.

Which framework categorizes patient-centered outcomes into the five dimensions of symptoms, functioning, health behaviors, healthcare utilization, and mortality?

Answer: NIH Patient-Reported Outcomes Research Framework

The NIH framework organizes PRO constructs into five outcome domains to guide standardized and comprehensive patient-centered measurement.

A healthcare analyst notices that a hospital's mortality rate drops sharply after implementing a new protocol, but case volume also decreased. The analyst should first consider:

Answer: Whether selection bias or changes in case mix explain the mortality improvement

Changes in which patients are admitted (case mix shift) or which are excluded can create apparent outcome improvements that are artifacts of selection rather than true protocol effects.

Which patient outcome measure is specifically designed to assess health literacy's impact on a patient's ability to manage their chronic condition?

Answer: Patient Activation Measure (PAM)

The Patient Activation Measure assesses the knowledge, skills, and confidence patients have to manage their own health, which correlates strongly with health literacy and self-management outcomes.