ABSTRACT
BACKGROUND: For a number of reasons, it has been difficult to garner public interest in the need to improve the quality of care delivered nationally. One possible reason for this is that the concept of quality has different meanings for different stakeholders. To make the problems of suboptimal quality more concrete and potential solutions more compelling, the Strategic Framework Board (SFB) recommended developing a set of national goals for quality improvement. OBJECTIVES: To describe the criteria by which national goals should be selected, illustrate the analytic methods that should be used to support the development of such goals, and describe and illustrate a process by which national goals could be formulated. RESEARCH DESIGN: Targeted review of literature and discussions among members of the SFB. FINDINGS: National goals have played a key role in making progress under the Healthy People 2000 and Health People 2010 initiatives. The recommended process will involve assembling key evidence as well as engaging in a consensus process. CONCLUSIONS: Developing a set of national goals for quality improvement is a key activity for a national quality measurement and reporting system to undertake. The steps outlined here represent a feasible and productive method for accomplishing this objective.
Subject(s)
Delivery of Health Care/standards , Quality Assurance, Health Care , Quality of Health Care/standards , Adult , Aged , Child , Female , Healthy People Programs , Heart Diseases/epidemiology , Heart Diseases/mortality , Heart Diseases/therapy , Humans , Male , Morbidity , Neoplasms/epidemiology , Neoplasms/mortality , Neoplasms/therapy , Prevalence , Quality of Life , United Kingdom , United States , United States Agency for Healthcare Research and Quality , World Health OrganizationABSTRACT
KIE: A major factor in the rise of health care costs has been the rapid dissemination of new medical devices and procedures without regard to cost effectiveness. The new reimbursement systems designed to reduce health expenditures will place the burden of evaluating technological advances on local decision makers, and an increased demand can be expected for reliable methods of assessing the costs and benefits of new technologies. Smits presents a simple, clinically-based model for determining a technology's potential for offering diagnostic and therapeutic benefits. She also discusses the role that factors such as cost, physician preference, and consumer demand play in singling out a new technology for study.^ieng
