HEALTH MEASUREMENT

项目总结(见说明)： 这一核心旨在支持和推进我们的努力，以克服风险调整和绩效衡量方面的重大缺陷，以确保任何保健改革(无论是目前立法的改革还是其他改革)都能提高效率。这一核心旨在为一项正在进行的倡议提供关键支持，该倡议旨在促进健康风险、健康结果和健康系统绩效衡量的科学，同时加速广泛采用更全面、更有意义和更可靠的健康风险和健康结果衡量标准。首先，核心将支持利用健康和退休调查(HRS)、基于地理的方法和从参与组织获得的患者报告措施，制定、测试和实施创新的风险和结果衡量标准。该核心将汇集制定项目5所述措施所需的数据库，并将提供基础设施，以支持三个参与的保健系统收集和使用患者报告的措施。其次，它将支持达特茅斯患者报告措施信托基金，该信托基金有两个不同但相关的目标：(A)与主要利益攸关方合作，就健康风险、健康结果和卫生系统绩效的有意义的指标达成共识，以及(B)帮助加快交付系统对这些措施的采用和使用。我们预计，这些合作努力可能在未来几年产生关键的红利--在子项目1、2和4中使用的广泛卫生系统中的患者报告的健康措施(和生物标记物)。最后，核心将向合作研究人员传播通过这项工作开发的先进措施。核心将能够向参与这项P01的其他调查人员(并通过核心A，在允许的情况下，研究界的其他人)提供以下关键措施：(A)创新的风险调整措施，用于使用联邦医疗保险数据和HRS数据进行所有与P01相关的分析；(B)在系统层面上创新的风险和绩效衡量标准，从3个试点开始，并(我们希望)扩大到更多的试点。

PROJECT SUMMARY (See instructions): This core is designed to support and advance our efforts to overcome the major shortcomings in risk adjustment and performance measurement needed to ensure that any health care reform (whether the currently legislated one or alternatives) results in improved efficiency. This Core is intended to provide key support for an ongoing initiative intended to advance the science of health risk, health outcome and health system performance measurement, while accelerating the broad scale adoption of more comprehensive, meaningful and reliable measures of health risk and health outcomes. First, the Core would support the development, testing and implementation of innovative measures of risk and outcome using Health and Retirement Survey (HRS), geographic based approaches and patient reported measures obtained from participating organizations. The core will assemble the databases needed to develop the measures described in Project 5 and will provide the infrastructure to support the collection and use of patient-reported measures by the three participating health systems. Second, it would support the Dartmouth Patient-Reported Measures Trust, which has two distinct but related goals: (a) to work with key stakeholders to build consensus on meaningful measures of health risks, health outcomes and health system performance, and (b) to help accelerate delivery system adoption and use of these measures. We anticipate that these collaborative efforts could yield key dividends in the next several years - patient-reported health measures (and biomarkers) across a wide range of health systems for use in Subprojects 1, 2, and 4. Finally, the Core would disseminate to collaborating investigators the advanced measures developed through this work. The Core will be able to provide to other investigators participating in this P01 (and through Core A, others in the research community where permissible) the following critical measures: (a) innovative measures for risk adjustment for use in all P01-related analyses using the Medicare data and HRS data; (b) innovative measures of risk and performance at the system level, beginning with the 3 pilot sites and (we hope) expanding to additional sites.