Structural versus outcomes measures in hospitals: a comparison of Joint Commission and Medicare outcomes scores in hospitals

Qual Manag Health Care. 2002 Winter;10(2):29-38. doi: 10.1097/00019514-200210020-00007.


Outcomes performance measures are increasingly important in health care. The Joint Commission on Accreditation of Healthcare Organizations (Joint Commission) continues to rely on structure and process measures based on accepted good practice. One of the first tasks in moving to a more outcomes-oriented approach is to compare the two measurement approaches. This article compares seven non-federal general hospital performance measures derived from Medicare against Joint Commission scores. Joint Commission measures are generally not correlated with outcome measures. The few significant correlations that appear are often counterintuitive. We conclude that a potentially serious disjuncture exists between the outcomes measures and Joint Commission evaluations.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accreditation
  • Benchmarking / statistics & numerical data*
  • Efficiency, Organizational
  • Hospital Costs / statistics & numerical data
  • Hospital Mortality
  • Hospitals, Community / economics
  • Hospitals, Community / standards*
  • Humans
  • Joint Commission on Accreditation of Healthcare Organizations*
  • Medicare*
  • Outcome and Process Assessment, Health Care*
  • Quality Indicators, Health Care*
  • United States / epidemiology