Book contents
- Frontmatter
- Contents
- Contents of Volume 2
- Preface and Reviewer Acknowledgments
- Chapter OneIntroduction
- Chapter TwoConceptual Models
- Chapter ThreeHistory and Evolution of Healthcare Performance Measurement
- Chapter FourTypes of Performance Measures
- Chapter FiveData Sources for Healthcare Quality Measurement
- Chapter SixHealthcare Performance Measure Attributes
- Chapter SevenTarget Conditions, Patient and Provider Observation Periods, and Attribution
- Chapter EightRisk Modeling and Validation
- Chapter NineSocial Risk Factors
- Chapter TenPerformance Classification and Outliers
- Chapter ElevenComposite Performance Measures
- Chapter TwelveData Presentation Strategies
- Chapter ThirteenPublic Reporting: Introduction, Ethical Considerations, and Outcomes
- Chapter FourteenPublic Reporting: Consumer Behavior and Market Impact
- Chapter FifteenUnintended Consequences
- Chapter SixteenWeb-Based Public Reporting
- Chapter SeventeenGraphical Approaches to Performance Assessments
- AppendixSelected Guidelines and Recommendations for Healthcare Performance Measures
- Bibliography
- Index
Chapter Eleven - Composite Performance Measures
Published online by Cambridge University Press: 11 August 2026
Book contents
- Frontmatter
- Contents
- Contents of Volume 2
- Preface and Reviewer Acknowledgments
- Chapter OneIntroduction
- Chapter TwoConceptual Models
- Chapter ThreeHistory and Evolution of Healthcare Performance Measurement
- Chapter FourTypes of Performance Measures
- Chapter FiveData Sources for Healthcare Quality Measurement
- Chapter SixHealthcare Performance Measure Attributes
- Chapter SevenTarget Conditions, Patient and Provider Observation Periods, and Attribution
- Chapter EightRisk Modeling and Validation
- Chapter NineSocial Risk Factors
- Chapter TenPerformance Classification and Outliers
- Chapter ElevenComposite Performance Measures
- Chapter TwelveData Presentation Strategies
- Chapter ThirteenPublic Reporting: Introduction, Ethical Considerations, and Outcomes
- Chapter FourteenPublic Reporting: Consumer Behavior and Market Impact
- Chapter FifteenUnintended Consequences
- Chapter SixteenWeb-Based Public Reporting
- Chapter SeventeenGraphical Approaches to Performance Assessments
- AppendixSelected Guidelines and Recommendations for Healthcare Performance Measures
- Bibliography
- Index
Summary
Composite performance measures offer numerous advantages over single measures, including multidimensional assessment of quality, more endpoints for analyses, and often higher reliability. Chapter 11 discusses these and other advantages as well as potential disadvantages such as greater methodological complexity, interpretability concerns, and the potential to obscure particularly good or bad results due to averaging. Both the classical psychometric conceptualization of composite measures and Feinstein’s clinimetric approach are discussed. A methodological framework is presented for the development of composite performance measures in healthcare, and examples are provided from several sources, including the CMS Hospital Quality Incentive Demonstration Project and the CMS Overall Hospital Quality Star Rating.
Information
- Type
- Chapter
- Information
- Healthcare Quality Measurement , pp. 239 - 256Publisher: Cambridge University PressPrint publication year: 2026
Accessibility standard: Inaccessible, or known limited accessibility
Why this information is here
This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.Accessibility Information
The PDF of this chapter is known to have missing or limited accessibility features. We may be reviewing its accessibility for future improvement, but final compliance is not yet assured and may be subject to legal exceptions. If you have any questions, please contact accessibility@cambridge.org.
Content Navigation
Table of contents navigation
Allows you to navigate directly to chapters, sections, or non‐text items through a linked table of contents, reducing the need for extensive scrolling.
Allows you to navigate directly to chapters, sections, or non‐text items through a linked table of contents, reducing the need for extensive scrolling.
Index navigation
Provides an interactive index, letting you go straight to where a term or subject appears in the text without manual searching.
Provides an interactive index, letting you go straight to where a term or subject appears in the text without manual searching.
Reading Order & Textual Equivalents
Single logical reading order
You will encounter all content (including footnotes, captions, etc.) in a clear, sequential flow, making it easier to follow with assistive tools like screen readers.
You will encounter all content (including footnotes, captions, etc.) in a clear, sequential flow, making it easier to follow with assistive tools like screen readers.
Short alternative textual descriptions
You get concise descriptions (for images, charts, or media clips), ensuring you do not miss crucial information when visual or audio elements are not accessible.
You get concise descriptions (for images, charts, or media clips), ensuring you do not miss crucial information when visual or audio elements are not accessible.