VOLUME 54 | NUMBER 2 | APRIL 2019
Hospital quality indicators are not unidimensional: A reanalysis of Lieberthal and Comer
Objective: To evaluate the dimensionality of hospital quality indicators treated as unidimensional in a prior publication.
Data Source/Study Design: Pooled crosssectional 20102011 Hospital Compare data (10/1/10 and 10/1/11 archives) and the 2012 American Hospital Association Annual Survey.
Data Extraction: We used 71 indicators of structure, process, and outcomes of hospital care in a principal component analysis of Ridit scores to evaluate the dimensionality of the indicators. We conducted an exploratory factor analysis using only the indicators in the Centers for Medicare & Medicaid Services' Hospital ValueBased Purchasing.
Principal Findings: There were four underlying dimensions of hospital quality: patient experience, mortality, and two clinical process dimensions.
Conclusions: Hospital quality should be measured using a variety of indicators reflecting different dimensions of quality. Treating hospital quality as unidimensional leads to erroneous conclusions about the performance of different hospitals.
Copyright© 2018, Health Research & Educational Trust. All rights reserved. Content Disclaimer
Health Research & Educational Trust, 155 North Wacker, 4th Floor Chicago, IL 60606 (312) 422.2600