Is the quality cart before the horse?
Article Abstract:
The Health Care Quality Improvement Initiative attempts to improve quality of medical care, particularly for Medicare patients. Emphasizing quality may be premature because the mechanisms for assessing quality and transmitting developed standards have not been finalized. Only six peer review organizations (PROs) are participating in a pilot test of the Uniform Clinical Data Set (UCDS), a 1600 variable quality of care evaluation tool. There is no published peer reviewed analysis of UCDS, which is still being developed. PROs disagree on the location of the data assembled under UCDS. PROs believe it should be under their local control while the Health Care Financing Administration (HCFA) wants data centralized under its auspices. The information, suggested policies and methods of relaying the information must reassure physicians and change their established behaviors. To be more effective, HCQII could gather less but more meaningful information, leave it with PROs, gather review criteria from established agencies, encourage research relationships between local PROs and universities on quality of care, encourage activities that evaluate medical competence and technical performance, analyze the organizational structure of this system and develop a detailed plan with specific objectives.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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Quality of care
Article Abstract:
The quality of medical care is increasingly being analyzed as managed care takes over more of the health care market. Organizations involved in developing assessment tools include the National Committee for Quality Assurance, the Foundation for Accountability, and the Joint Commission on Accreditation of Healthcare Organizations. However, there are conflicts between groups that want to measure what services were provided to patients and those that want to measure patient outcome.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1997
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