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Outcomes Benchmarking

The term outcomes benchmarking refers to an attempt to answer the question, "How does a patient's, clinician's or organization's outcome compare to a benchmark or expected outcome?" Of course, any attempt to establish a benchmark requires some methodology for case mix adjustment.

Broadly speaking, there are two types of benchmarks: external and internal. External benchmarks make comparisons using a threshold that is established externally (e.g., comparison to a national average). For example, Takuya Minami, Ph.D. and colleagues have recently published a series of articles describing a methodology for benchmarking real world outcomes against results from clinical trials.

Internal benchmarks rely upon the organization's own norms (e.g., comparing the outcome for an individual client's to an expected outcome based upon the organizations client population). For larger organizations that generate large samples sizes from multiple sites, internal benchmarks have the advantage of providing the opportunity to assure that the case mix adjustment model is valid for the population being served. Internal benchmarks also are useful for examining change in outcomes over time for an organization.

However, internal benchmarks tell us little about how the organizations outcomes compare to that of other organizations and benchmarks from clinical trails.

ACORN outcomes reports uses the term Benchmark Target when referring to the predicted final score for a patient.

The term Benchmark Score is used when referring to the difference between the most recent (or last) GDS score in the treatment episode and the Benchmark Target. A positive Benchmark Score indicates a better than average outcome.

The Acorn Criteria for Effectiveness (ACE) provides an example of how to combine methodologies for internal and external benchmarking to produce standardized reports of clinical effectiveness.

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-- JebBrown - 10 Jan 2007
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