John W. Finney|Keith Humphreys|Daniel R. Kivlahan|Alex H. S. Harris
Why Health Care Process Performance Measures Can Have Different Relationships to Outcomes for Patients and Hospitals: Understanding the Ecological Fallacy
Quality Enhancement Research Initiative|Quality Enhancement Research Initiative|Quality Enhancement Research Initiative|Quality Enhancement Research Initiative
relationships health care process performance measures ppms outcomes differ magnitude even direction patients versus higher level units eg health care facilities discrepancies arise facilitylevel relationships ignore ppmoutcome relationships patients within facilities may different confounders patientlevel ppmoutcome relationships may reflect facility effect modification patient ppmoutcome relationships patientlevel ppm related better patient outcomes care process encouraged however finding multilevel analysis proportion patients receiving ppm care across facilities nevertheless linked poor hospital outcomes would suggest interventions targeting health care facility also needed