MSR37 Meaningful Difference in Performance (MDP): A Proposed Method to Improve Evaluation of Meaningful Variation Healthcare Quality Measures

Abstract

A National Quality Forum’s “must pass” criterion for endorsing healthcare quality measures is the existence of a quality gap - “considerable variation, or overall less-than-optimal performance, in the quality of care across providers”. However, methods to determine if gaps exist are either informal, arbitrary, or based on statistical tests of differences from mean performance or other benchmarks. The objective of our work is to develop a conceptual and statistical foundation for incorporating patient and stakeholder perspectives into operationalizing a new concept: Meaningful Difference in Performance (MDP). If a MDP between providers does not exist, then patients, clinicians, and healthcare systems might be saved tremendous effort and resources needed to implement measures that will not be valuable in driving improvements.