医者のグループにおける品質保証. 強調はどこにあるのか?
関連する実験動画
E A Kerr1, B S Mittman, R D Hays
1Department of Medicine, University of California, Los Angeles, USA.
JAMA
|October 16, 1996
まとめ
Capitated医師団は,過度の使用に対する過剰使用の監視,および慢性疾患管理に対する予防的ケアを強調しています. 品質保証 (QA) プログラムは,特に慢性疾患のケアにおいて,未十分な使用に対処する必要があります.
科学分野:
- ヘルスケア・マネジメント・ヘルスケア・マネジメント
- 品質保証 品質保証について
- 医者のグループ事業運営
背景:
- キャピテーションモデルでは,品質保証 (QA) の責任が医師グループにシフトします.
- 医者のグループのQAプログラムは,その焦点と有効性によって異なります.
- 品質保証活動の理解は,キャピテッド・システムにおける医療の提供を改善するために極めて重要です.
研究 の 目的:
- 医者のグループにおける品質保証 (QA) プログラムについて説明する.
- 品質保証における過剰使用対不足使用,予防対慢性疾患のケアに対する重点を評価する.
- 医者のグループ特性がQA活動にどのように影響するかを調べる.
主な方法:
- 医者のグループに配布された横断的なアンケート.
- 研究には,カリフォルニアの大規模なネットワークモデル医療維持組織内の94の医師グループが含まれていました.
- 自己報告された品質監視および改善方法について収集されたデータ.
主要な成果:
- 調査対象となったすべての医師グループは,何らかの形でQAを実施していた.
- 品質保証プログラムでは,過度の使用 (例:帝王切開) と過度の使用 (例:免疫) と比較して,不均衡に監視されました.
- 予防的なサービスは慢性疾患のフォローアップケアよりもQAの注目を集め,長寿や収益性などのグループの特徴がQAの活動に影響を与えた.
結論:
- キャピテーションモデルは,医師グループに重要な品質管理責任を負わせていますが,その範囲は不均一です.
- キャピテーションにおける財政的インセンティブは,過度の使用に焦点を当て,測定の課題は慢性疾患のケアモニタリングに影響を与える可能性があります.
- QAプログラムの拡張は,特に慢性疾患の不足モニタリングを含むように推奨されます.
関連する概念動画
01:30Health Information Technology and Healthcare Information System
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
01:26Methods Of Healthcare Delivery System
At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:29Issues And Trends In Healthcare Delivery System
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
01:29Documentation in Long-Term and Home Healthcare Setting
Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Long-Term Care Facilities
01:15Methods of Documentation VI: Case Management Model
The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
For example, a patient with a chronic illness...
01:18Introduction To Health Care Delivery System
The healthcare system is constantly changing and complex. Various services are available from different healthcare providers, but gaining access to these services has become challenging for people with limited healthcare insurance. Uninsured people present a challenge to healthcare because they frequently postpone or forego treatment.
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...
The Institute of Medicine (IOM) advocates for a patient-centered, effective, safe, timely, equitable, and effective healthcare system. The National Priorities...