Evaluation of psychosocial health care in quality assurance activities

This article documents the extent to which one type of quality assurance activity--the medical audit--includes evaluation of psychosocial aspects of health and disease. The criteria used for 448 medical audits completed in the Minneapolis-St. Paul area from 1975 to 1979 are examined in terms of three kinds of psychosocial criteria--those dealing with impact of illness, psychosocial consultation and psychosocial history, plus a fourth kind of criteria concerned with patient education. The majority of medical audits examined address no psychosocial or patient education criteria whatsoever (78 and 63 percent, respectively). Audits of psychiatric diagnoses are more likely to include psychosocial criteria than those of surgical, pediatric, medical, or obstetrical-gynecological diagnoses; on the other hand, pediatrics and psychiatry are most likely to include patient-education criteria. Furthermore, of the four kinds of criteria studied, those concerned with patient education are the most frequently found. It is recommended that methods to evaluate psychosocial health care be developed and implemented within the sphere of quality assurance activities, in order to more comprehensively define the quality of medical care.