Comparing analytic approaches to evaluating quality performance in trauma care

The need to assess the performance of the healthcare system in order to improve quality and reduce costs has gained increasing attention in recent years. In 2001 the Institute of Medicine (IOM) proposed the use of six quality aims to guide improvement efforts. However, most healthcare quality studies still focus on a single dimension, often along the effectiveness or timeliness aims. This study investigates the viability of using all the IOM quality aims in the analysis of trauma care quality. It used data from the Michigan Trauma Quality Improvement Program to identify and quantify quality metrics associated with each IOM aim. Correlation analysis was used to identify relationships between metrics, and composite measures were developed to represent each aim. The traditional, univariate analysis approach to evaluating trauma care performance was compared with two other approaches involving more than one quality aim: a single comprehensive composite measure approach and a multivariate quality analysis approach.