Health Care Quality Measures Remain Resilient Amid Localized Disasters

In part 2 of our interview with Maria DeYoreo, PhD, senior statistician at the RAND Corporation and codirector of the RAND Center for Causal Inference, she discusses the key findings of her study, "Do Localized Disasters Impact Clinical Measures of Health Care Quality?," published in the February 2025 issue of The American Journal of Managed Care®.

DeYoreo also addresses a limitation of the study that may have impacted the findings.

Watch part 1 of the interview to learn more about the study's inspiration and objectives.

This transcript has been lightly edited for clarity; captions were auto-generated.

Transcript

Can you discuss the main findings? Were there any that surprised you?

The main finding was that we did not find evidence that geographically limited disasters meaningfully reduced annual quality performance scores. Of the measures examined, most had no statistically significant disaster impacts, and the 2 that did were not meaningfully affected.

Overall, it's somewhat surprising that disasters, including destructive hurricanes, as well as wildfires and earthquakes, did not meaningfully affect performance scores. We had anticipated that disasters may impact measures that required in-person clinical or preventive care, such as diabetes eye exam measures, or time-sensitive measures, like getting care quickly.

What do these findings suggest about the overall resilience of quality measurement programs in disaster-affected areas?

These findings suggest that program sponsors may continue to use these quality measures to evaluate provider performance in the presence of short-term, localized disasters, like the ones that were included in our analysis.

This also indicates that programs like this are resilient to major disasters that are localized and limited in duration.

What were the key limitations of your study? How might they have impacted your findings?

One big limitation is that our results only apply to disasters of similar duration and scale to the ones observed in our study period, which covered the years 2016 to 2018.

It's certainly possible that larger-scale disasters of longer duration may have more sustained impacts on health care delivery. However, we did not include such disasters in our analysis as they weren't observed during this time period.