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Gestión de la calidad por parte de las agencias estatales de Medicaid que se convierten en atención administrada:
B E Landon1, C Tobias, A M Epstein
1Brigham and Women's Hospital, Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
JAMA
|January 23, 1998
Resumen
Las agencias estatales de Medicaid están mejorando el monitoreo de calidad de los planes de atención administrada. Muchos estados planean recopilar más datos y compartir información con planes de salud y beneficiarios para mejorar la calidad de la atención.
Área de la Ciencia:
- Servicios de salud Servicios de salud Investigación Investigación.
- Política de salud pública Política de salud pública.
- Aseguramiento de la calidad de la atención administrada.
Sus antecedentes:
- La inscripción en el cuidado administrado de Medicaid ha aumentado significativamente.
- Comprender la supervisión estatal de la calidad en estos programas es crucial.
Objetivo del estudio:
- Evaluar las actividades de monitoreo y aseguramiento de calidad de las agencias estatales de Medicaid.
- Centrarse en programas integrales de cuidado administrado prepago.
Principales métodos:
- Encuesta telefónica estructurada de las 34 agencias estatales de Medicaid (y DC) con inscripción en atención administrada.
- Datos recopilados entre octubre de 1996 y enero de 1997.
Principales resultados:
- Los 34 estados registraron a los beneficiarios de Ayuda a Familias con Hijos Dependientes (AFDC, por sus siglas en inglés); el 62% registró a discapacitados, el 44% a ancianos.
- En 1995-1996, el 63% recogió datos sobre la satisfacción del paciente, el 83% sobre las vacunas infantiles.
- Muchos estados planearon aumentar la recopilación de datos y compartirlos con planes de salud y beneficiarios para 1997.
Conclusiones:
- Las agencias estatales de Medicaid están desarrollando activamente sus roles como compradores de atención médica.
- El monitoreo continuo es vital para garantizar que se implementen las iniciativas de calidad planificadas y se mantenga o mejore la atención a los inscritos en Medicaid.
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