Making the health care delivery system accountable.

Area of Science:

• Healthcare Management
• Health Services Research

Background:

• Accountability in healthcare has traditionally focused on legal liability or financial performance.
• Managed care entities primarily evaluate accountability through financial outcomes.

Purpose of the Study:

• To explore the ramifications of financial considerations on healthcare accountability.
• To emphasize the need for appropriate measurement tools for evaluating healthcare services, delivery, performance, customer satisfaction, and outcomes.
• To address the complexities of accountability stemming from the unresolved question of 'Who is the customer?'

Main Methods:

• The article reviews the concept of accountability within the healthcare industry.
• It discusses the necessity and application of measurement tools for various aspects of healthcare delivery.
• It considers the responsibilities of all stakeholders, including insurers, employers, management, providers, and recipients.

Main Results:

• Accountability extends beyond simple cost containment and financial reduction.
• The identification of the 'customer' is fundamental to resolving complex accountability issues.
• Effective accountability requires evaluating costs and impacts over time.

Conclusions:

• True healthcare accountability is achieved through the implementation of valid and appropriate quality and measurement concepts.
• Addressing stakeholder responsibilities and defining the customer are critical steps.
• Measurement tools are essential for a comprehensive assessment of healthcare delivery and performance.