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Portrait of Anders Anell. Photo.

Anders Anell

Professor

Portrait of Anders Anell. Photo.

Process measures or patient reported experience measures (PREMs) for comparing performance across providers? : A study of measures related to access and continuity in Swedish primary care

Author

  • Anna Glenngård
  • Anders Anell

Summary, in English

Aim: To study (a) the covariation between patient reported experience measures (PREMs) and registered process measures of access and continuity when ranking providers in a primary care setting, and (b) whether registered process measures or PREMs provided more or less information about potential linkages between levels of access and continuity and explaining variables. Background: Access and continuity are important objectives in primary care. They can be measured through registered process measures or PREMs. These measures do not necessarily converge in terms of outcomes. Patient views are affected by factors not necessarily reflecting quality of services. Results from surveys are often uncertain due to low response rates, particularly in vulnerable groups. The quality of process measures, on the other hand, may be influenced by registration practices and are often more easy to manipulate. With increased transparency and use of quality measures for management and governance purposes, knowledge about the pros and cons of using different measures to assess the performance across providers are important. Methods: Four regression models were developed with registered process measures and PREMs of access and continuity as dependent variables. Independent variables were characteristics of providers as well as geographical location and degree of competition facing providers. Data were taken from two large Swedish county councils. Findings: Although ranking of providers is sensitive to the measure used, the results suggest that providers performing well with respect to one measure also tended to perform well with respect to the other. As process measures are easier and quicker to collect they may be looked upon as the preferred option. PREMs were better than process measures when exploring factors that contributed to variation in performance across providers in our study; however, if the purpose of comparison is continuous learning and development of services, a combination of PREMs and registered measures may be the preferred option. Above all, our findings points towards the importance of a pre-analysis of the measures in use; to explore the pros and cons if measures are used for different purposes before they are put into

Department/s

  • Department of Business Administration

Publishing year

2018-01

Language

English

Pages

23-32

Publication/Series

Primary health care research & development

Volume

19

Issue

01

Document type

Journal article

Publisher

Cambridge University Press

Topic

  • Health Care Service and Management, Health Policy and Services and Health Economy

Keywords

  • access
  • continuity
  • PREM
  • primary care
  • process measures
  • quality of care

Status

Published

Project

  • Public Management Research

ISBN/ISSN/Other

  • ISSN: 1463-4236