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Quality-of-Care Assessment by Process and Outcome Scoring: Use of Weighted Algorithmic Assessment Criteria for Evaluation of Emergency Room Care of Women with Symptoms of Urinary Tract Infection

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▸Requests for reprints should be addressed to Lisa Rubenstein, M.D.; 556 Midvale Avenue, Apartment 1; Los Angeles, CA 90024.

Bronx, New York

Ann Intern Med. 1977;86(5):617-625. doi:10.7326/0003-4819-86-5-617
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Weighted process criteria based on chart review using an algorithmic method, and weighted outcome criteria based on a telephone interview with the patient, were used to assess the quality of emergency room care of women with symptoms of acute urinary tract infection. Outcomes at a municipal hospital were significantly better than those at an affiliated voluntary hospital. Process and outcome scores were positively correlated at both hospitals; the data suggest, but do not themselves adequately test, the hypothesis that the correlation is curvilinear and that there is a threshold process score below which a poor outcome is extremely likely. Our findings suggest that weighted algorithmic assessment criteria are a useful method for quality assessment and are consistent with the testable hypothesis that the greatest improvements in outcome may result from raising the quality of care from a poor to an adequate level rather than from an adequate to an optimal level.





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