AHRQ--Agency for Healthcare Research and Quality: Advancing Excellence in Health Care

Quality Indicator Resources

  • AHRQ Quality Indicator Empirical Methods, Revised March 2015

    Describes the empirical methods used to calculate AHRQ QIs.

  • Improving the AHRQ Quality Indicators, December 2014

    Summary of findings and recommendations for improving the methodological approach of the AHRQ Quality Indicators.

    NOTE: Persons using assistive technology may not be able to fully access information in this document. For assistance contact the Quality Indicators support at (301) 427-1949 or by email at: QIsupport@ahrq.hhs.gov

  • AHRQ ICD-10-CM/PCS Conversion Project, Nov 2013

    Documents the process and status of converting AHRQ QIs from ICD-9-CM to ICD-10-CM/PCS.

  • ICD-9-CM to ICD-10-CM/PCS Conversion of AHRQ Quality Indicators, March 2011

    Background information on the transition from ICD-9-CM to ICD-10-CM and ICD-10-PCS for HIPAA transactions

  • AHRQ RAHM Workgroup Technical Report

    Describes the data structure, statistical models, and tools used in the AHRQ QI Project and proposes alternative statistical models and methods for consideration

  • Calculating Standard Errors and Confidence Intervals for the AHRQ Quality Indicators

  • The Markov Chain Monte Carlo Integration Approximation in the AHRQ QI Prediction Module Closely Matches Exact Integration Results, Posted February 19, 2014

    Summarizes testing on prediction models.

  • Guidance on Using the AHRQ QIs for Hospital-Level Comparative Reporting, June 2009

    Guidance on use for public reporting and payment initiatives including analysis of each indicator’s appropriateness and reporting templates.

  • Summary Statement on Comparative Hospital Public Reporting

    How public reporting of hospital quality performance data and advances the quality improvement agenda in health care.

  • AHRQ QI Model Report

    Templates for reporting comparative hospital performance information

AHRQ QIs for Home and Community Based Services (HCBS)

This set of indicators reflect the health and well-being of beneficiaries receiving home and community-based services (HCBS) through state Medicaid programs. They focus on potentially preventable hospitalizations. For additional information on the development of the HCBS QIs, view the resources below:

  • Literature Review

    Provides guidance for using AHRQ QIs for public reporting and payment initiatives; includes analysis of each indicator to determine their appropriateness for use in comparative reporting and comparative reporting templates based on input from consumers, providers, experts in the field of public reporting, and others.

  • Expert Panels

    Summarizes HCBS panel comments on the validity of the HCBS indictors as a set, factors that panelists believe might impact hospitalizations for the indicator conditions or events in the HCBS populations and panelists' comments and concerns about each indicator.

Life Cycle of the AHRQ QIs

Developing the Indicators

The AHRQ QI measure development process involves four phases.

Phase 1: Candidate Indicator Development
  • Identify candidate indicators within areas of interest.
  • Review literature.
  • Finalize specifications.
  • Summarize evidence.
Phase 4: Retire Indicators
  • Review evidence on the use of the indicator and determine that retirement is needed.
  • Remove coding from software and user documentation.
AHRQ QI Lifecycle Image
Phase 2: Implement New Indicator
  • Code the new indicator into the software.
  • Test the new indicator.
  • Develop user documentation.
Phase 3: Maintain Existing Indicators
  • Review evidence on the use of the indicator.
  • Update technical specifications.
  • Periodic review by clinical panels.
  • Consider new data and methodological advances.

These phases and processes sometimes may require modifications to meet the needs of indicator development in new areas. For a more in-depth explanation, see the reports below.

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