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Department of Health and Human Services

Topic Suggestion Description

Date submitted: May 20, 2014

Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.
What are the benefits and risks of using functional status and health-related quality of life as health outcomes for quality indicators for the elderly and patients with multiple comorbid conditions?
Potential benefits could include evidence for improved outcomes and quality of care with use of these quality indicators; potential harms include patient burden, incomplete reporting and data, and adverse patient selection by physicians due to the difficulty of impacting these outcomes.


Describe why this topic is important.
Adapted from the JAGS article attached:
Although functional status and health-related quality of life (HRQOL)
are important outcomes for people with multiple chronic conditions (MCCs) and are currently being developed by several key stakeholders, including the Centers for Medicare & Medicaid Services. However, evidence is unclear on the use of quality indicators for functional status
and HRQOL that would be relevant for populations with
MCCs. The indicators that exist are used for specific populations
or settings and have problems with feasibility and
usability. Although a recent systematic review addressed evidence to support interventions for improving QOL and functional status, this review could not be applied to the issue of quality measurement. It is unclear
whether measuring HRQOL and functional status, or implementing
quality indicators using these tools, affects patient
status or quality of care. Measurement tools for functional
status may not capture the effect of interventions aimed at
preventing or ameliorating functional decline. Furthermore,
the evidence base may not be sufficiently robust for endorsement
of indicators that hold providers accountable for preventing
or reversing functional decline in populations of
older adults with MCCs in the ambulatory setting. Dedicated research is
needed to systematically evaluate
usability and feasibility of implementing quality indicators.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?
This will help organizations and national quality groups better understand what evidence supports improvement in quality for patients with multiple chronic conditions.

Nominator Information

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