'Black box' medical information systems: a technology needing assessment

Article Abstract:

Due to soaring costs, the health care system is constantly being evaluated with regard to cost, necessity and quality of medical services. One means of analyzing the quality of medical care is MedisGroups (Medical Illness Severity Grouping System). This system was designed to evaluate medical care in hospitals so that individuals could use the information as a guide when choosing a health care facility. The state of Pennsylvania requires all hospitals to use MedisGroups, so that health care can be evaluated within a specific hospital and compared among various hospitals. The method that MedisGroups uses for its evaluation is not clear. In an article by Blumberg at al. in the June 12, 1991 issue of The Journal of the American Medical Association, a comparison of data estimated from MedisGroups and the observed data in a particular field of medicine, survival from heart attack, has revealed shortcomings in the MedisGroups system. The analysis of the methodology used by MedisGroups is important because such rating systems have significant impact on individuals in need of health care and on hospitals as well. The MedisGroups system is used by insurance companies to encourage people to obtain medical care from certain institutions and not others. This can have a significant effect on the futures of various hospitals. A formal process is needed to analyze the reliability of this assessment tool. Strict standards must be applied to information systems so that the information that is generated is accurate and used appropriately. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Medical economics, Medical care, Quality management, Medical care quality, Hospitalization, Medical informatics, Hospital care, editorial

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Turning the disability tide

Article Abstract:

The increasing risk and rate of potentially disabling conditions among children and working-age adults in the United States is discussed. Various programs and strategies are being developed to treat the disabilities in people.

United States, Government domestic functions, Accident & Health Insurance, Insurance Carriers, Public affairs, Services information, Direct Health and Medical Insurance Carriers, Hospital and medical service plans, Medical Care Insurance, Social aspects, Care and treatment, Services, Risk factors, Health insurance, Disability, Disabilities, Health policy

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