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Symposium on data in a capitated environment. Honeywell Inc.

Miller LL - Health Care Financ Rev (1986)

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ABSTRACT

Inpatient days per 1,000 covered population per year (age and sex adjusted).

Inpatient admissions per 1,000 covered population per year (age and sex adjusted).

Average length of stay per inpatient admission by major service category: medicine, surgery, maternity, psychiatry, chemical dependency, rehabilitation.

Number of surgical procedures performed per 1,000 covered population per year (age and sex adjusted).

Number of outpatient encounters per person per year.

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Elements of a health maintenance organization quality assurance system
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f2-hcfr-86-supp-075: Elements of a health maintenance organization quality assurance system

Mentions: Finally, a quality assurance system is necessary for an HMO to monitor its overall success or failure. Donabedian (1983) argues that the core of a quality assurance system is client satisfaction. Members' preferences are the ultimate measure of the contribution of an HMO to welfare and well-being. Satisfaction to an HMO member means two things. First and foremost, it means satisfaction with the outcome of care, which is reflective of the technical effectiveness of the medical care system. Did the patient recover completely from the limitations in social and physiological functioning imposed by an illness? Was the recovery timely? Satisfaction also means comfort, convenience, access, and personal attention—the psychosocial aspects of care. Was care available when and where requested? Was it provided in pleasant surroundings by professionals who demonstrated concern for individuals' needs and desires? Because HMO's control the entire spectrum of medical technology, as well as the organization and delivery of services, they have a correspondently greater responsibility for member health status and satisfaction than do FFS providers. Description of an adequate quality assurance system is beyond the scope of this article and has been covered elsewhere. (For example, see Freeborn and Greenlick, 1973.) Some critical elements of an HMO quality assurance system are highlighted in Figure 1.


Symposium on data in a capitated environment. Honeywell Inc.

Miller LL - Health Care Financ Rev (1986)

Elements of a health maintenance organization quality assurance system
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4195084&req=5

f2-hcfr-86-supp-075: Elements of a health maintenance organization quality assurance system
Mentions: Finally, a quality assurance system is necessary for an HMO to monitor its overall success or failure. Donabedian (1983) argues that the core of a quality assurance system is client satisfaction. Members' preferences are the ultimate measure of the contribution of an HMO to welfare and well-being. Satisfaction to an HMO member means two things. First and foremost, it means satisfaction with the outcome of care, which is reflective of the technical effectiveness of the medical care system. Did the patient recover completely from the limitations in social and physiological functioning imposed by an illness? Was the recovery timely? Satisfaction also means comfort, convenience, access, and personal attention—the psychosocial aspects of care. Was care available when and where requested? Was it provided in pleasant surroundings by professionals who demonstrated concern for individuals' needs and desires? Because HMO's control the entire spectrum of medical technology, as well as the organization and delivery of services, they have a correspondently greater responsibility for member health status and satisfaction than do FFS providers. Description of an adequate quality assurance system is beyond the scope of this article and has been covered elsewhere. (For example, see Freeborn and Greenlick, 1973.) Some critical elements of an HMO quality assurance system are highlighted in Figure 1.

View Article: PubMed Central - PubMed

ABSTRACT

Inpatient days per 1,000 covered population per year (age and sex adjusted).

Inpatient admissions per 1,000 covered population per year (age and sex adjusted).

Average length of stay per inpatient admission by major service category: medicine, surgery, maternity, psychiatry, chemical dependency, rehabilitation.

Number of surgical procedures performed per 1,000 covered population per year (age and sex adjusted).

Number of outpatient encounters per person per year.

Show MeSH