摘要:

Ambulatory care practice is evolving rapidly in response to market forces and changing opportunities and challenges within provider organizations. The author examines how four sets of players in the ambulatory care sector—patients, providers, payers, and investors—are influencing the efficiency of ambulatory care. The article's conceptual framework integrates the roles of those system players with the determinants of efficiency (broadly defined): technology, incentives, structure, processes, constraints, and norms. The empirical literature sheds light on several of these efficiency determinants.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

This article discusses the experience of 11 large health care systems in their attempts to improve quality of care. It focuses on four of the six performance characteristics outlined inCrossing the Quality Chasm, the second report of the Institute of Medicine (IOM): improved effectiveness, renewed focus on patients, timeliness and convenience, and efficiency. For example, all of the systems have been making substantial investments in clinical information systems and are beginning to see some of the benefits, including improved quality and coordination of care. Although the Institute of Medicine's report found that major reform of the U.S. health care system is needed, it is encouraging that a number of organizations are putting forth a significant effort toward improving performance and are making progress in the achievement of their improvement goals.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Corporate purchasers of health care benefits for employees and their dependents are beginning to demand the use of information technology in health care for purposes of improving quality. Level of investment in information technology is directly related to net income for hospitals. The proper choice of investment in information technology is associated with financial stability and supporting patient-centered care in medical groups. Empirical studies of health care services in outpatient facilities and clinics indicate opportunities for significant improvements in quality by focusing a very small set of treatment protocols.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Information technology provides an opportunity for the health care industry to fulfill its mandate for delivering high-quality care in a cost-effective manner. Technical developments, such as the Intranet and computer-based medical records; regulatory mandates; and employer cooperative groups are pushing the industry toward paying increased attention to the quality and cost of care. The spread of information technology has heightened public interest in the quality of care and in participating in clinical decisions related to an individual's health. This consumer-centered paradigm will further increase the role of information technology in the health care industry.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

This study explores the adoption of electronic information systems by 120 medical group practices within a managed care environment and analyzes the characteristics of medical groups that influence this process. While almost all the clinics have financial related systems, the group practices are not invested extensively in patient care information technologies. The factors influencing the adoption of these technologies remain obscure. The value of patient care and pharmacy systems seems to remain unproven in a health care industry that focuses on implementing systems that provide a more immediate impact on information required to survive in highly competitive markets.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The Institute of Medicine's reportTo Err Is Humanwas a catalyst for concern regarding quality, patient safety, and medical errors. The most effective actions will occur in the federal health care system. Revision of research agendas, accreditation, and education standards will also be successful. Regulatory changes and legislative initiatives will come about more slowly. The application of information technology will be slowed by costs and lack of infrastructure and of standards. Reporting systems will be resisted. Changes will continue incrementally until the cost of enabling information technology falls and medical groups compete on the basis of quality.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

This article describes the Maine Medical Assessment Foundation's Outcomes Dissemination Project, which ran from 1991 to 1996. The goal of the project was to evaluate the process of physician education and feedback that had been developed by the foundation.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Measurement is critical to improving quality, but it can be counterproductive to mix measurement methods appropriate for basic research with measurement methods needed for documenting process improvement in health care delivery. This article describes some basic statistical concepts needed to develop and implement a simple process improvement plan and a simple tool for assessing the effectiveness of interventions. The approach described can be used to improve operational or clinical processes.

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:0148-9917    

出版商:OVID    

年代:2002

数据来源: OVID