OBJECTIVES. This article describes one approach to measuring outcomes
across the continuum of care. METHODS. Development and testing of the
outcome-based quality-improvement methodology as developed by the Univ
ersity of Colorado Center for Health Services Research in Denver, Colo
rado are summarized. RESULTS. Reliable and valid measures for home hea
lth care covering end results (pure outcome), intermediate results (in
strumental outcome), and use (proxy outcome) were developed and are us
eful in demonstrating patient improvement or stabilization as well as
decline. Further, these measures can be aggregated by agency and, with
appropriate severity or risk adjustment, can be used to compare outco
mes over time and across agencies. CONCLUSIONS. National testing of th
e methodology is currently ongoing, with refinements underway in measu
res, risk adjustment, and operational implementation.