Term
| What is the IOM definition of quality? |
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Definition
| The degree to which health svs for individuals and populations increase the likelihood of desired outcomes and are consistant with current professional knowledge |
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Term
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Definition
| Iatrogenesis and iatrogenic artifect refer to an adverse effect or complications resulting from medical treatment or advice |
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Term
| Who is the joint commission? |
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Definition
The leading health care accrediting body in the WORLD.
16,000 health care organizations in the US |
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Term
| What are the factors contributing to the quality movement? |
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Definition
inc in quality health care data
inc in ublics demand for provider accountability, positive pt outcomes
lucien leape |
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Term
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Definition
| Differene between health processes/outcomes and those throght to be achievable (w the most current and professional knowledge) |
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Term
| What are the demensins of quality? |
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Definition
There is a macro view and a microview
macorview-clinical, technical, interpersonal aspects, wiality of life
Micro view - mortality, incidence nd prevalence |
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Term
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Definition
Institutional settings
individual providers
direct provision of clinical sertvices
pt satisfaction
prosperity or retroprosperity |
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Term
| What are the critical components of a quality assessment |
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Definition
MEASUREMENT of wuality agains an established standard
Use of DATA
Subjective measures must be QUANTIFIED
msasurement SCALES must have validity and realiability |
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Term
| What is the DONABEDIAN model approach to quality assessment? |
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Definition
Structure (environment, necessary)
-staffing levels, equiptment, qualificatios, traing, dist of phys in a given population
Process (how the care is delivered)
-clinical practice guidelines, critical pathways (timeline, ids medical intervetions)
outcome (end result from care provided)
-the bototm line measure of effectivebness, post op infections, iatrgenic illnesses, rehospitalization, pt satisfaction |
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Term
| What arre the quality aspects of care? |
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Definition
Structure and process
(the amenities and the technology |
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Term
| What is quality assurance? |
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Definition
Based on total quality management
a step beyon quality assessment
a syetem wide commitment to enguage in the improvement of quality on an ongoing baseis |
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Term
| What is the relationship between quality and cost? |
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Definition
quality can cost moeny
moent does not nec allways buy wuality improvements |
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Term
| What are some of the problems that affect Quality? |
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Definition
overuse - extra stuff
underuse - pts donet get what they need
misuse - injuries caused by error (amputate the wrong foot) |
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Term
| What are the 6 IOM coponents of quality? |
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Definition
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Term
| How are some report cards that are used in the quality of care? |
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Definition
state reporting
quality indicares
CMS program |
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Term
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Definition
| a tool that is used by more than 90% of americas health plas to measure preformance on important dimenstions of care and service |
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Term
| What does CAHPS stand for? |
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Definition
| Consumer assessment of health plans survey |
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Term
| What does OSHPD stand for? |
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Definition
| Office of statewide health planning and development |
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Term
| How does the standardization of health care contribute to health care quality? |
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Definition
benchmakring
quality assessments
evidence based practice guidelines
increased emphasis onn outcome measures |
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Term
| What are some of the quality improvement stratigies for the future? |
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Definition
focus on basic and cost effective preventative care
availability of healthcare data
indentify the geographic locations in need of health care services and ID sucerssful prograkms for addressing those needs |
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Term
| In a regulatory approach, what is a single payer system? |
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Definition
top down control (global budgets)
The US DOES NOT hagve an all payer system
-bottom up cost control
-COST SHIFTING ocuurs |
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Term
| In a regulatory approach, what is health planning? |
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Definition
govts efforts to align and distribute health resources to achieve health outcomes
NO system wide planning and controls in the US
-CON planning is used in some states |
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Term
| What are some price controls in regulartory planning? |
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Definition
-ecoonomic stabilizatin uding the non nixon presidencey
-provider-induced demand mitigated the effects of price control
-DRG bases PPS shifted costs to the OUTPT selector
-arbutuary rate setting by medicaid
-pay fof performance |
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Term
| What is peer review in regulartory planning? |
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Definition
-peer review organizations (PRO)
statewide private organiztions
revew by phys and other health professionals
paid by fed govt
to review care provided to medicare pts
easch state has a PRO
PROS are now called WAULITY IMPROVEMENT ORGS (QIOS) |
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Term
| What are some competetive approaches to cost containment |
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Definition
demand side incentives
suply side regulation
payer driven price competeition
utilization controls
conpetition
-rivalry among sellers for customers |
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Term
| What are some demind side incentives? |
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Definition
cost sharing by consumers
a self rationing mechanism
-reduced moral hazard
RAND experiment |
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Term
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Definition
anti trust laws
anticompetetive practices can be illegal |
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Term
| How are pts not cuswtomers in the ecconomic sense? |
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Definition
they pay little out of pocket
lack technical informatioikn
-competitio occurs at two leves: employer shop and MC shops for providers |
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Term
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Definition
| The ability to obtain needed affordable convienient acceptable and efective personal health services timely |
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Term
| WHat are key implications of access? |
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Definition
determinant of health
quity
quality and efficient use of svs that are needed |
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Term
| What are some evidence based medicine (EBM)? |
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Definition
high spending does not deliver bertter outcomes
Better value throughevidencec based medicine
quality can be improved while reducing costs by reducing misuse and over sd
the ACA calls for the creation of patient centered outcomes research institute |
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Term
| What are some evidence based medicine stratigies? |
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Definition
ongoing emphysis
computer based systems
ongoing clinical trials
keep guidelines current
inhance cost effeciivnesss fo care delivery w economic analysis
restruction reimbursment to reward achievable coutcomes that are best |
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Term
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Definition
| extent to which it actually assesses what it is supposed to measure |
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Term
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Definition
| extent to which the sake results occur from repeated applications |
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Term
| What are two quality improvement stratigies? |
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Definition
| Standardization and reoprt cards |
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Term
| How do you spell that quality guys name? |
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Definition
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