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Appropriateness in patient care: a new conceptual framework
1Office of the Dean of Research and Graduate Education, Georgtown University Medical Center, Washington, DC 20007, USA.
The Milbank Quarterly
|January 1, 1996
Summary
Health services evaluation now prioritizes appropriateness research over unnecessary procedures. This shift emphasizes evidence-based practice, aiming to control costs and enhance patient care quality through multiple perspectives.
Area of Science:
- Health Services Research
- Medical Ethics
- Health Economics
Background:
- Shift in health services evaluation from unnecessary treatment to appropriateness research.
- Increased focus on the evidentiary basis of medical and surgical practices.
- Appropriateness evaluation is key to containing healthcare costs and improving quality.
Purpose of the Study:
- To clarify the concept of appropriateness in patient care.
- To define sources of value that inform appropriateness.
- To explore the implications for medical futility.
Main Methods:
- Conceptual analysis of "appropriateness" in healthcare.
- Definition of three value perspectives: clinical, patient, and societal.
- Application of the framework to medical futility.
Main Results:
- Appropriateness is defined by clinical, individual patient, and societal values.
- This framework provides a structured approach to evaluating healthcare services.
- The concept helps illuminate discussions on medical futility.
Conclusions:
- Clarifying appropriateness is crucial for evidence-based healthcare decision-making.
- A multi-perspective framework (clinical, patient, societal) enhances understanding of appropriateness.
- The framework offers insights into managing medical futility and optimizing resource allocation.