There are several factors associated with the rise in health care spending. These factors are apart from general inflation in the economy. Read this Power Point presentation on Health Care Cost Factors associated with rising health care costs.
Quality of Care
“Quality” has been overshadowed by the emphasis placed on access and costs of health care delivery. One major factor causing this phenomenon is the difficulty associated with defining and measuring “quality.” This difficulty notwithstanding, in recent years “quality” has taken center stage primarily due to the growth of managed care and its emphasis on control of utilization and cost containment. The concern is that managed care’s focus on utilization and costs has and will continue to adversely impact quality of care.
The Institute of Medicine has defined quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”
In its report, Crossing the Quality Chasm, the IOM specifies six guiding aims for principles of change in reforming the American healthcare system: Health care should be safe, effective, patient-centered, timely, efficient, and equitable.
Some excellent articles can be found in the IOM web site – click here and input quality as your search word.
Quality Assessment refers to the measurement of quality against an established standard. It includes the processes of defining how quality is to be determined, identification of variables or indicators to be measured, statistical analysis, and interpretation of data. (Shi & Singh, 2005)
Quality Assurance is a step beyond quality assessment, and is defined as the process of institutionalizing quality through ongoing assessment and using the results for continuous quality improvement. Quality Assurance is a system wide commitment to engage in ongoing improvement of quality.
See this Power Point presentation on Quality Implications.
Continuity of Care
Continuity is said to be a multidimensional relationship between the patient and care received. It includes factors such as medical record retention/accuracy, patient tracking, visits with same providers, follow-up appointments – generally everything associated with a continuum of care.
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Module 2 – Background
Standards of Evaluation
If you cannot locate an article in one set of databases (e.g., EBSCO), try to locate it in ProQuest.
Required Reading
California Department of Managed Health Care (2013). Continuity of care. Retrieved from https://www.dmhc.ca.gov/HealthCareinCalifornia/YourHealthCareRights/ContinuityofCare.aspx
Davis, K., et al. (2006). Mirror, Mirror on the Wall: An Update on the Quality of American Health Care Through the Patient’s Lens. The Commonwealth Fund. Retrieved from http://www.commonwealthfund.org/Publications/Fund-Reports/2006/Apr/Mirror–Mirror-on-the-Wall–An-Update-on-the-Quality-of-American-Health-Care-Through-the-Patients-Le.aspx
Hoeksema, J.. (2011). Taking Steps to Control Costs in the OR. Association of Operating Room Nurses. AORN Journal, 94(6), S79-84; quiz S85-6.
Lasser, K. E., Himmelstein, D. U. and Woodlander, S. (2006). Access to Care, Health Status, and Health Disparities in the United States and Canada: Results of a Cross-National Population-Based Survey. American Journal of Public Health 96 (7); 1300.
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