An overview of outcomes research and measurement.

Rapidly rising healthcare costs, questions about effective medical intervention, and the need for efficient delivery of healthcare services have compelled organizations to focus on outcomes research, measurement, and management. Proponents of outcomes measurement predict that it will produce significant benefits, including improved physician and patient information, increased understanding of the effectiveness of different treatment interventions, and established guidelines for medical management. Multiple professional organizations, academic centers, and independent research laboratories, as well as government agencies, are now involved in the research and development of outcomes measurement tools. This article provides some insight into the outcomes phenomenon.

Enhancing quality and controlling costs: using Internet technology to apply workflow to health care.

The pressures associated with the competitive, quickly changing health care marketplace require the use of all available tools to deliver the highest quality care at the lowest cost. Workflow, as employed by other industries, delivers significant increases in both productivity and quality of services. Likewise, the application of automated workflow techniques to the health care industry offers measurable and immediate benefits. The very nature of a workflow product requires that it be available as widely as possible and be customized to fit the working patterns of the people who use it. To gain the advantages of customization and wide platform access, it is mandatory that the burgeoning technologies of the Internet be used in the creation of any modern networked computer application. Automated health care workflow provides the necessary information technology for caregivers to deliver efficient and effective high-quality care.

The effect of a school entry law on mumps activity in a school district.

Sixty-three cases of clinical mumps occurring in a New Jersey school district presented an opportunity to determine compliance with the state's 1978 mumps "new entrants" school immunization law, investigate the effect of the law on the pattern of the outbreak, estimate the efficacy of mumps vaccine, and quantitate the economic impact of the outbreak. Only students in kindergarten (K) through grade 5 would have been affected by the immunization law. Students in the sixth grade were nearly seven times more likely to develop mumps than students in grades K through 5. The observed differences between the sixth graders and those in grades K through 5 most likely reflect the fact that sixth graders were not covered by the school law. Vaccine efficacy was estimated to be 91% (95% confidence interval = 77% to 93%). The total direct cost of the outbreak was $10,937 (clinic costs plus total cost to households). This outbreak demonstrates the significant impact of appropriate school vaccination laws on limiting the morbidity and economic and social costs of mumps.

The probability of dying of injuries by the year 2000.

Life tables in which the probability of dying of injuries in the United States from 1985 to 1999 are determined may be useful for clinicians in counseling persons concerning the risk of fatal injuries. Overall, more than 1% of persons aged 10 to 34 years in 1985 probably will die of injuries by the year 2000. For white males aged 5 to 29 years in 1985, white females aged 5 to 19 years in 1985, and black males aged 5 to 24 years in 1985, over half of all the estimated deaths during the next 15 years will be probably due to injuries.