Volume 54 | Number 2 | April 2019

Abstract List

Matthew S. Cefalu PhD, Marc N. Elliott, Claude M. Setodji PhD, Paul D. Cleary Ph.D., Ron D. Hays


To evaluate the dimensionality of hospital quality indicators treated as unidimensional in a prior publication.

Data Source/Study Design

Pooled cross‐sectional 2010‐2011 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 Value‐Based Purchasing.

Principal Findings

There were four underlying dimensions of hospital quality: patient experience, mortality, and two clinical process dimensions.


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.