• Reut Israeli, Gil A Geva, and Adam J Rose.
• Braun School of Public Health and Community Medicine, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. israelireut@gmail.com.
• J Gen Intern Med. 2025 Jan 28.

BackgroundQuality of care can be measured in several dimensions: different clinical disciplines, structures/processes/outcomes of care (SPO), and also different domains of quality (effectiveness, safety, care coordination, patient-centeredness, efficiency, timeliness, and community/population health). To our knowledge, no previous study has compared different sets of performance measures in terms of how well they cover these different aspects of quality.ObjectiveCompare the content coverage of major quality measure sets from Israel, the US, and the UK.DesignReview and categorization of performance measure sets, with disagreements between reviewers resolved through consensus.Main MeasuresWe selected three sets of quality measures: HEDIS, the Healthcare Effectiveness Data and Information Set (USA), QOF, the Quality and Outcomes Framework (UK), and QICH, Quality Indicators for Community Healthcare (Israel). All measures were classified along three dimensions-clinical specialty, SPO, and seven domains of healthcare quality. We then compared the distribution of measures in each of the three sets, using Fischer's exact tests and post hoc tests of pairwise differences.Key ResultsIn the medical specialty domain, all three countries focused primarily on family medicine/primary care. All three measure sets focused heavily on process measures, though to different extents, and all emphasized effectiveness of care, community/population health, and communication and care coordination over other domains of quality.ConclusionsThe measure sets we examined, which overwhelmingly measure processes of care, should be encouraged to add structure and outcomes measures. All three measure sets under-emphasize certain aspects of quality such as timeliness, care coordination, efficiency, and patient-centeredness. Finally, and most importantly, all three measure sets focused overwhelmingly on measuring the activities of family physicians; attention should be given to building measures that will examine the activities of other clinicians.© 2025. The Author(s), under exclusive licence to Society of General Internal Medicine.

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