Medicare [electronic resource] : Volume 1 : a strategy for quality assurance / Committee to Design a Strategy for Quality Review and Assurance in Medicare, Division of Health Care Services, Institute of Medicine, Division of Health Care Services ; Kathleen N. Lohr, editor.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Division of Health Care Services.

Contributor:

Lohr, Kathleen N., 1941-

Series:

IOM publication ; 90-02.

Language:

English

Subjects (All):

Medical care--Quality control.

Medical care.

Medicare.

Physical Description:

1 online resource (468 p.)

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1990.

Language Note:

English

Summary:

Health care for the elderly American is among our nation's more pressing social issues. Our society wishes to ensure quality health care for all older people, but there is growing concern about our ability to maintain and improve quality in the face of efforts to contain health care costs. Medicare: A Strategy for Quality Assurance answers the U.S. Congress' call for the Institute of Medicine to design a strategic plan for assessing and assuring the quality of medical care for the elderly. This book presents a proposed strategic plan for improving quality assurance in the Medicare program, along with steps and timetables for implementing the plan by the year 2000 and the 10 recommendations for action by Congress. The book explores quality of care--how it is defined, measured, and improved--and reviews different types of quality problems. Major issues that affect approaches to assessing and assuring quality are examined. Medicare: A Strategy for Quality Assurance will be immediately useful to a wide audience, including policymakers, health administrators, individual providers, specialists in issues of the older American, researchers, educators, and students.

Contents:

""MEDICARE""; ""Copyright""; ""Contents""; ""Preface""; ""Introduction to the Study and This Report""; ""CONGRESSIONAL CHARGE""; ""STUDY METHODS""; ""ORGANIZATION OF THIS REPORT""; ""Summary""; ""FINDINGS AND CONCLUSIONS""; ""A MODEL OF QUALITY ASSURANCE FOR MEDICARE""; ""DEFINING QUALITY OF CARE""; ""RECOMMENDATIONS""; ""Medicare Mission and Quality Assurance""; ""Quality Assurance Goals of the Medicare Program""; ""Medicare Program to Assure Quality (MPAQ)""; ""Public Accountability and Evaluation""; ""Hospital Conditions of Participation""; ""Research and Capacity Building""; ""FUNDING""

""ORGANIZATIONAL AND OPERATIONAL FEATURES OF THE MEDICARE PROGRAM TO ASSURE QUALITY""""Starting Points""; ""Structure""; ""The Federal and Local Levels""; ""The Internal Organization-Based Level""; ""Operational Overview of the Proposed Model""; ""An Emphasis on Outcomes""; ""The Importance of the Process of Care""; ""Continuity of Quality Assessment""; ""Potential Problems""; ""IMPLEMENTATION STRATEGY AND PHASES""; ""Phase I: Years 1 and 2""; ""Phase II: Years 2 through 8""; ""Data Collection""; ""Data Analysis Capabilities""; ""Information Dissemination""; ""Special Projects""

""Phase III: Years 9 and 10""""CONCLUDING REMARKS""; ""1 Health, Health Care, and Quality of Care ""; ""DEFINING QUALITY OF HEALTH CARE""; ""Elements of the Committee's Definition""; ""Implications of the Committee's Definition""; ""HEALTH AND HEALTH CARE IN THE UNITED STATES""; ""Health and Illness""; ""Structure of the U.S. Health Care System""; ""Major Health Policy Issues with Implications for Quality of Care""; ""Health Care Expenditures""; ""Access to Services""; ""Settings of Care""; ""Integration of Financing and Delivery of Services""

""Utilization Management and Utilization Review""""Medicare's Physician Payment System""; ""Summary""; ""QUALITY OF HEALTH CARE AS A PUBLIC POLICY ISSUE""; ""Burden of Harm of Poor Quality""; ""Assuring Quality: A Professional and a Public Responsibility""; ""Professional Responsibilities""; ""Public Sector Responsibilities and Regulation""; ""Health Care as a Public Good""; ""Other Forces for Quality Assurance""; ""Market Forces and Competition""; ""Malpractice and Risk Management""; ""Value Purchasing""; ""Decision Making and Population-Based Outcomes""; ""SUMMARY""; ""NOTES""

""REFERENCES""""2 Concepts of Assessing, Assuring, and Improving Quality ""; ""QUALITY ASSESSMENT, QUALITY ASSURANCE, AND QUALITY IMPROVEMENT""; ""Definitions""; ""Purposes of Quality Assurance""; ""Internal and External Programs""; ""CRITERIA FOR JUDGING AN EFFECTIVE QUALITY ASSURANCE PROGRAM""; ""QUALITY ASSURANCE CONCEPTUAL MODELS""; ""The Traditional Structure-Process-Outcome Model""; ""Structure""; ""Process""; ""Outcomes""; ""Continuous Quality Improvement""; ""Four Core Assumptions""; ""Eight Key Constructs""; ""Applications""

""Quality Assurance Concepts from an International Perspective""

Notes:

"This study was supported by the Health Care Financing Administration, U.S. Department of Health and Human Services, under cooperative agreement no. 17-C-99170/3"--T.p. verso.

Includes bibliographical references and indexes.

ISBN:

9786610212637

9781280212635

1280212632

9780309593397

0309593395

9780585339757

0585339759

OCLC:

923273964