The use of negative indexes of health to evaluate quality of care in a primary-care group practice.

ABSTRACT

A quality assessment method using negative indexes of health as a measure of the quality of medical care was applied in a hospital-based primary-care group practice. During a 5-year period, records of 1,147 patients were analyzed. The study led to several observations regarding the use of this method in this setting: 1) The negative indexes of health method encourages physicians to include both primary and secondary preventive measures in their practice of medicine and to see their role as a broad one, from providing good care to individual patients to influencing public policy. 2) Most medical records do not now contain all the data required for use of this method. 3) In cases where this method identifies only a few instances of possibly preventable disease or untimely death, it is impossible to know whether the care is good and the method of evaluation is sensitive, or whether the care is poor and the method is insensitive to deficiencies in care.