Practice parameters versus outcome measurements. How will prospective and retrospective approaches to quality...

There have been increasing efforts to manage quality and costs in health care. Two tools that are used to do this are practice parameters and outcome measurements. Practice parameters are strategies for patient management to assist clinicians in clinical decision making. Outcome measurements inform clinicians and the public about performance in the delivery of care. Federal and state health care legislation make use of these two concepts as a way to monitor and improve quality and costs, reduce liability, and in some cases, promote competition. Practice guidelines are more limiting to clinicians, but may reduce their liability and help some meet expected clinical outcomes. Outcome criteria alone provide more flexibility to clinicians in deciding how to improve clinical outcome and reduce costs, and enable patients to select care givers on the basis of performance.