Long-term care for frail elderly people -- the On Lok model

Article Abstract:

On Lok Senior Health Services of San Francisco has served as a model for such programs throughout the country. This program transports disabled elderly patients to a day care center for health and supportive services and returns them to their homes at night. This allows them to avoid being placed in a nursing home and allows their caregivers to keep their day jobs. The Program of All-Inclusive Care for the Elderly (PACE) was modeled on this program and there are now 24 PACE sites throughout the US. Whether these programs can be extended to all disabled elderly Americans remains to be seen.

Aged, Elderly, Innovations, Long-term care of the sick, Long term care

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The American health care system: the movement for improved quality in health care

Article Abstract:

Many dedicated people are trying to improve the quality of health care in the US. The proponents of health care quality are concerned with the overuse, underuse and misuse of health care services. Groups include the National Committee for Quality Assurance, the Foundation for Accountability, the Institute for Healthcare Improvement, the National Patient Safety Foundation, the National Roundtable on Health Care Quality and the Consumer Coalition for Quality Health Care. This movement is not just about reducing health care costs but is prompted by a real concern for patient outcomes.

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The unintended consequences of measuring quality on the quality of medical care

Article Abstract:

Doctors and accrediting agencies need to look for the unintended consequences of measuring the quality of medical care. The number of children who were vaccinated or the number of women who had a mastectomy is easy to count. However, some measures of quality are, in fact, hard to measure. Focusing on things that can be measured at the expense of those that can't may lead to misallocation of resources and time. It will also naturally miss those things that can't be counted. And it may lower the morale of the doctors who must collect the data.

Analysis, Total quality management

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