Medicare--new directions in quality assurance : proceedings of an invitational conference

Medicare--new directions in quality assurance proceedings of an invitational conference

Detalles Bibliográficos
Autor Corporativo: Institute of Medicine (U.S.). Division of Health Care Services (-)
Otros Autores: Donaldson, Molla S. (-), Harris-Wehling, Jo, 1941-, Lohr, Kathleen N., 1941-
Formato: Libro electrónico
Idioma:Inglés
Publicado: Washington, D.C. : National Academy Press 1991.
Edición:1st ed
Materias:
Medicare > Congresses.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820323806719
Tabla de Contenidos:
  • Medicare
  • Copyright
  • Acknowledgments
  • Contents
  • PART I Introduction
  • 1 Introduction
  • QUALITY OF CARE AND QUALITY ASSURANCE FOR MEDICARE
  • THE INSTITUTE OF MEDICINE STUDY
  • THE INSTITUTE OF MEDICINE CONFERENCE ON MEDICARE: NEW DIRECTIONS IN QUALITY ASSURANCE
  • THE CONFERENCE AGENDA
  • 2 The Institute of Medicine Report
  • CHARGES TO THE COMMITTEE
  • DEFINING QUALITY OF CARE
  • FINDINGS
  • Health Care and Health of the Elderly
  • Burden of Harm
  • Approaches to Quality Assurance
  • Peer Review Organizations
  • Capacity Building
  • A STRATEGY FOR MEDICARE QUALITY ASSURANCE
  • Mission and Goals of Medicare Program
  • Medicare Program to Assure Quality
  • REFERENCES
  • PART II New Directions: More Professionalism, Less Regulation
  • New Directions: More Professionalism, Less Regulation
  • INTRODUCTION
  • 3 More Professionalism, Less Regulation: The Committee View
  • PROFESSIONALISM
  • RESPONSIVENESS TO OUTCOMES
  • COMPETITIVENESS
  • PRIDE
  • CONCLUSIONS
  • REFERENCES
  • 4 More Professionalism, Less Regulation: A Response
  • PROGRAMMATIC CONSIDERATIONS
  • PRACTICE PARAMETERS
  • AMERICAN MEDICAL ASSOCIATION (AMA) GUIDELINES FOR QUALITY ASSURANCE
  • RESEARCH AND PEER REVIEW
  • CONCLUSION
  • REFERENCE
  • PART III New Directions: Organization- and System-Focused Quality Improvement
  • New Directions: Organization- and System-Focused Quality Improvement
  • INTRODUCTION
  • REFERENCES
  • 5 Organization- and System-Focused Quality Improvement: The Committee View
  • QUALITY IMPROVEMENT AND OUTCOMES
  • THE ROLE QUALITY IMPROVEMENT PLAYS
  • REFERENCES
  • 6 Organization- and System-Focused Quality Improvement: A Response
  • QUALITY IMPROVEMENT POLICY AT WEST PACES FERRY HOSPITAL
  • RELATING QUALITY ASSURANCE TO QUALITY IMPROVEMENT
  • THE INSTITUTE OF MEDICINE REPORT FROM A CONTINUOUS IMPROVEMENT PERSPECTIVE.
  • Continuous Improvement as a Preferred Model
  • The Power of Locally Developed Initiatives
  • Quality Improvement Education
  • Supportive Methods of Public Review and Oversight
  • Community Hospitals as Focal Points of Quality Improvement
  • SUMMARY
  • REFERENCES
  • PART IV New Directions: Improved Decisionmaking by Patients and Clinicians
  • New Directions: Improved Decisionmaking by Patients and Clinicians
  • INTRODUCTION
  • 7 Improved Decisionmaking by Patients and Clinicians: The Committee View
  • FIRST-ORDER RESEARCH
  • APPLYING THE RESULTS OF EFFECTIVENESS RESEARCH TO PATIENT CARE
  • SHARED DECISIONMAKING
  • BARRIERS AND INCENTIVES TO IMPROVEMENT
  • SUMMARY
  • REFERENCES
  • 8 Improved Decisionmaking by Patients and Clinicians: A Response
  • PATIENT PERSPECTIVES ON HEALTH CARE QUALITY
  • INFORMATION NEEDS
  • ISSUES CONCERNING PATIENT INFORMATION
  • SUMMARY
  • REFERENCES
  • PART V New Directions: A Patient Outcomes Orientation
  • New Directions: A Patient Outcomes Orientation
  • INTRODUCTION
  • 9 A Patient Outcomes Orientation: The Committee View
  • PROCESSES, OUTCOMES, AND PATIENT CHOICES
  • INFORMED DECISIONMAKING
  • CLINICAL PRACTICE AS A SOURCE OF KNOWLEDGE
  • PATIENT VALUES
  • OUTCOMES AND QUALITY ASSURANCE
  • SUMMARY
  • REFERENCES
  • 10 A Patient Outcomes Orientation: A Response
  • OUTCOMES OF CARE
  • APPROPRIATENESS OF CARE
  • PATIENT VALUES
  • FUTURE ADVANCES IN DECISIONMAKING
  • OUTCOMES RESEARCH
  • QUALITY, RESOURCES, AND PRACTICE PATTERNS
  • REFERENCES
  • PART VI New Directions: Public Accountability and Program Evaluation
  • New Directions: Public Accountability and Program Evaluation
  • INTRODUCTION
  • 11 Public Accountability and Program Evaluation: The Committee View
  • BACKGROUND
  • REFERENCES
  • 12 Public Accountability and Program Evaluation: A Response
  • NEED FOR CHANGES
  • PROGRAM EVALUATION
  • CONCLUDING REMARKS
  • REFERENCE.
  • PART VII Confronting Special Implementation Issues
  • Confronting Special Implementation Issues:
  • INTRODUCTION
  • REFERENCES
  • 13 Confronting Special Implementation Issues: The Epidemiology of Quality Problems
  • THREE TYPES OF QUALITY PROBLEMS
  • Evidence of Quality Problems
  • The Overlap Between Overuse and Poor Technical Quality
  • Discouraging Overuse and Overcoming Underuse
  • Improving Technical Quality
  • CONCLUSIONS
  • REFERENCES
  • 14 Confronting Special Implementation Issues: Legal Concerns
  • MALPRACTICE
  • LEGAL INCENTIVES TO PERFORMANCE
  • Positive Inducements
  • Protection for Peer Review
  • Interventions and Sanctions
  • DUE PROCESS
  • Shifting Standards of Behavior
  • DATA PROTECTION AND RELEASE
  • CONCLUSIONS
  • REFERENCES
  • 15 Confronting Special Implementation Issues: Translating the Institute of Medicine Report Strategy Beyond Medicare
  • MAJOR THEMES OF THE INSTITUTE OF MEDICINE REPORT
  • Antecedent Processes and the Outputs of Health Care
  • Seven Derivative Themes
  • NEEDS OF HEALTH CARE ORGANIZATIONS
  • STRATEGIES FOR DIFFUSION
  • Gain Acceptance of Shared Responsibility
  • Remove Major Barriers
  • Develop and Disseminate Models
  • Enhancing Coordination
  • CLOSING REMARKS
  • REFERENCES
  • PART VIII New Directions: The Research, Training, and Capacity Building Agendas
  • New Directions: The Research, Training, and Capacity Building Agendas
  • INTRODUCTION
  • 16 Research and Capacity Building: Issues Raised by the Institute of Medicine Report
  • VARIABILITY
  • PROCESS MEASURES
  • ART OF CARE
  • OUTCOMES
  • Severity Adjustment
  • Health Status
  • CONTINUOUS IMPROVEMENT
  • LINK BETWEEN PROCESS AND OUTCOME
  • PRACTICE GUIDELINES
  • SPECIAL SETTINGS
  • Ambulatory Care
  • Long-Term and Community-Based Care
  • Health Maintenance Organizations
  • Rural Settings
  • FINANCING
  • DIFFUSION
  • CAPACITY BUILDING
  • FUNDING.
  • REFERENCES
  • 17 The Research Agenda: An Outside View
  • THE NEED FOR RESEARCH
  • JOINING BASIC AND APPLIED RESEARCH
  • STRUCTURE, PROCESS, AND OUTCOMES
  • GENERALIZABILITY
  • PATIENT AND PHYSICIAN PARTICIPATION
  • SUMMARY
  • REFERENCES
  • 18 The Training and Capacity Building Agendas: An Outside View
  • PERSONNEL TRAINING
  • CURRICULUM DEVELOPMENT
  • RELATED TRAINING NEEDS
  • PATIENT EDUCATION
  • SUMMARY
  • REFERENCES
  • PART IX Response to the Institute of Medicine Report Recommendations
  • Response to the Institute of Medicine Report Recommendations:
  • INTRODUCTION
  • REFERENCES
  • 19 A Legislator's Response to the Institute of Medicine Report
  • THE INSTITUTE OF MEDICINE REPORT
  • ADDRESSING PROBLEMS OF UNDERUSE
  • FUTURE DIRECTION OF HEALTH POLICY
  • ASSURING QUALITY OF CARE IN THE FUTURE
  • Insurance Reform
  • CLOSING REMARKS
  • REFERENCE
  • 20 A Legislator's Response to the Institute of Medicine Report
  • ACCESS FOR MEDICARE ENROLLEES
  • A COMPREHENSIVE STRATEGY
  • CONCERN ABOUT COST CONTAINMENT AND MEDICARE
  • CONGRESSIONAL INTEREST
  • CONCERNS ABOUT PRACTICING PHYSICIANS
  • ADDITIONAL CONCERNS
  • CONGRESSIONAL RESPONSIBILITY
  • REFERENCE
  • 21 A Physician's Response to the Institute of Medicine Report
  • CONCERNS ABOUT THE PROPOSED STRATEGY
  • ECONOMIC ASPECTS OF QUALITY CONCERNS
  • PROFESSIONALISM
  • LEGAL ISSUES
  • COST OF THE NEW PROGRAM
  • SUMMARY
  • REFERENCES
  • 22 An Administration Response to the Institute of Medicine Report from the Agency for Health Care P ...
  • THE AGENCY FOR HEALTH CARE POLICY AND RESEARCH
  • MEDICAL TREATMENT EFFECTIVENESS PROGRAM
  • QUALITY EVALUATION AND IMPROVEMENT INITIATIVE
  • MEDICAL LIABILITY PROGRAM
  • SUMMARY
  • REFERENCE
  • 23 An Administration Response to the Institute of Medicine Report from the Health Care Financing Administration.
  • PROBLEM AREAS IDENTIFIED BY THE HEALTH CARE FINANCING ADMINISTRATION IN THE PAST
  • THE HEALTH CARE FINANCING ADMINISTRATION'S STRATEGY FOR PEER REVIEW
  • THE UNIFORM CLINICAL DATA SET ACTIVITY
  • OTHER ACTIVITIES SPONSORED BY THE HEALTH CARE FINANCING ADMINISTRATION
  • CONCLUDING REMARKS
  • REFERENCE
  • APPENDIX QUALITY ACTIVITIES OF THE HEALTH CARE FINANCING ADMINISTRATION
  • 24 A Peer Review Organization Response to the Institute of Medicine Report
  • NEW DIRECTIONS SUPPORTED BY THE PRO COMMUNITY
  • CONTINUING NEED FOR RECORD REVIEW
  • SUMMARY
  • REFERENCES
  • PART X Where Do We Go From Here?
  • Where Do We Go From Here?
  • INTRODUCTION
  • 25 Where Do We Go From Here?
  • CURRENT MECHANISMS FOR ASSURING QUALITY CARE
  • Medical Education and Board Certification
  • Hospital Accreditation
  • COMMENTS ON THE INSTITUTE OF MEDICINE RECOMMENDATIONS
  • SUMMARY
  • REFERENCE
  • 26 Where Do We Go From Here?
  • WHERE TO GO FROM HERE?
  • PATIENT OUTCOMES
  • EMPHASIZING PROFESSIONALISM
  • LONG-TERM STRATEGIES
  • RESEARCH, TRAINING, AND CAPACITY BUILDING
  • UTILITY OF THE STRATEGY
  • CONCLUDING REMARKS
  • REFERENCES
  • List of Authors.

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