Evaluation Of Medical Care Research Articles

Auditing care with a problem-oriented record system

The trend toward formal evaluation of medical care prompted the examination of the quality and economy of care in the emergency department of Beth Israel Medical Center. Two sources were used to obtain the information for the evaluation. The first was the Emergency Department Utilization Review Committee which meets every other week to review emergency department charts. The second was a study to determine the speed of audit and time to fatigue in auditing emergency department charts. The results showed that auditors could review problem-oriented charts in less time and in greater numbers with less fatigue than traditional charts.

Narrowing the gap between medical and mental health evaluation.

Some of the problems facing evaluators of medical care have been dealt with by individuals examining mental health programs. Mental health research has focused more on outcome studies that include a multidimensional approach in evaluation. Techniques have been devised in that field that make the evaluative process patient specific and goal oriented. Borrowing some of these methods to make medical care evaluation include a problem-oriented outcome, which incorporates patient satisfaction, compliance with medical therapy, and relief of symptoms, could lead to more accurate data on the health delivery system.

Editorial: EMCROs and the evaluation of medical care.

Editorials1 February 1975EMCROs and the Evaluation of Medical CareBEVERLY C. PAYNE, M.D., F.A.C.P.BEVERLY C. PAYNE, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-2-276 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptNine Experimental Medical Care Review Organizations (EMCROs) were encouraged and funded by the National Center for Health Services Research in 1971. What was their mission, their purpose? The apparent answer was to prepare and demonstrate a rational method for evaluation of institutional medical care with attention to effective use of those institutions in maintaining or achieving an acceptable level of quality care within them. The nine EMCROs mounted parallel programs that combined health-services research and demonstrations based on available methodologies. All nine developed structurally similar criteria for evaluation of the medical diagnostic and therapeutic process. Each was properly concerned with...

The paucity of course work in medical care evaluation.

In view of the current emphasis on measurement of the quality of health care services, reflected in regulatory provisions and accreditation requirements, an inquiry was made as to the extent to which medical schools are presently offering formal training in the techniques of medical care evaluation. Of 118 medical schools surveyed, 24 responded with the information that they are actually providing such training. The training reported ranged from a one-hour lecture to five elective courses. The implications of the findings are discussed with reference to the need of physicians to become familiar with the principles and methods of scientific evaluation of medical care. Some of the areas that might be covered in courses on evaluation are discussed, and examples of two current programs are given.

Primary Medical Care Evaluation

A study design to compare and evaluate different systems of primary medical delivery in the United States was devised. The concept of an indicator case (common in all systems of primary care) was used as a convenient way to sample and evaluate medical delivery. Eight criteria, including both cure and care aspects, were used to measure and compare different primary systems. Data were collected by a trained group of nurse-interviewers and very little of the physician's time was required. A unique aspect of this study is that it was conceived and worked out in detail over a five-year period cooperatively by a group of practicing physicians representing the American Academy of Family Physicians and experienced medical researchers from the School of Public Health of the University of North Carolina. (JAMA230:1668-1673, 1974)

Primary medical care evaluation. The AAFP-UNC collaborative study

Primary medical care evaluation. The AAFP-UNC collaborative study

Medical Audit by Clinical Rounds

The authors describe a system of medical care evaluation (or audit) that is an alternative to systems requiring extensive electronic data processing and is of practical use on psychiatric services....

Quality of care in emergency services.

Excerpt To the editor: We wish to add our experience in the evaluation of emergency medical care in Baltimore to that of Brook, Berg, and Schechter (Ann Intern Med78:333-339, 1973). In a previous s...

Medical care evaluation studies. A utilization review requirement

Medical care evaluation studies. A utilization review requirement

Medical Care Evaluation Studies A Utilization Review Requirement

Medicine has long placed emphasis on the quality as well as the quantity aspects of care. Forthcoming revised Medicare utilization review regulations, carefully weighing the experiences of the first five years of the Medicare program, will reflect this emphasis. The concept of evaluating the appropriateness of care received by the patient is far from new. Various methods, both formal and informal, have been used by the medical profession for decades. But the advent of Medicare, with its utilization review requirements, has created a focus on efficient use of resources as well as on the medical necessity of professional services furnished. Unfortunately, one aspect of the utilization review requirements has proved confusing to both Medicare institutions and their staffs. This is the requirement for "sample review," a title that is inaccurate and confusing. This communication introduces a more descriptive title, "medical care evaluation study," to replace it and describes how an

Patients' evaluation of outpatient medical care.

150 patients attending an outpatient clinic at the University of Oklahoma Hospital over a 5-week period were asked whether the clinic care they were receiving was better than, as good as, or worse than the care they had received from local physicians. The patients were drawn from the general medicine, cardiology, and oncology-hematology units and tended to be elderly and chronically ill. Most of the patients viewed favorably the care they received in the medical outpatient clinics. 65% reported they had experienced pain or discomfort in the week prior to their visit, but there was no association between these factors and degree of satisfaction with clinic care. Patients averaged about 30 minutes with the physician, and 80% felt the doctor adequately explained their medical condition to them. Patients who rated the clinic care as being worse than the care of private practitioners felt that their condition was not adequately explained. When asked to define a "good doctor," patient responses were "interest in the patient," "skilled and thorough," and "explains things to you." Characteristics identified as being most important in a "good clinic" were; good doctors, well-trained staff, and information from doctors. Of all the factors examined, the one associated most directly with patient satisfaction was personal interest on the part of the physician in the patients.

Evaluation of medical and dental care under the Medical Assistance program.

Evaluation of medical and dental care under the Medical Assistance program. I J Brightman, and N C AllawayCopyRight https://doi.org/10.2105/AJPH.59.12.2215 Published Online: August 29, 2011

Evaluation of the quality of mental health services.

PROGRAM evaluation studies are notable for the large number of people in favor of doing them and the small number of people who actually try. This is very understandable considering both the importance of good information about the usefulness of various health programs and the extreme difficulty of obtaining this information. In the area of mental health programs, the call for studies is, if anything, louder, and the number of studies, fewer. In a time of expanding programs and rising costs, this is an unfortunate situation which demands a high priority of attention. It is our purpose here to examine one type of program evaluation—evaluation of the quality of mental health services—and to suggest in what ways immediate progress in the field may be possible. The stimulus of our consideration is a paper by Donabedian 1 in which he discusses quality evaluation of medical care. We will not repeat what

The Evaluation of Medical Care Under Public Law 89-239

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Evolution of the Medical Audit

The first effective demand for the systematic review and scientific evaluation of medical care that is now termed "medical audit" originated soon after 1910. Surgery had gained great popular favor in the years just past when the dramatic relief of suffering and disability and the prolongation of life that were offered by surgery at its best had overcome much of the former dread of the hospital and surgeon. Although the need for welltrained surgeons far exceeded the available supply at that time, there was a surplus of poorly trained surgeons. The medical literature of the day, particularly Flexner's famous survey of medical education, gives us the picture of a greatly overcrowded profession made up in large part of poorly educated doctors. In the period between 1900 and 1909, some 165 medical schools had been turning out 5,200 doctors annually, a majority of whom had not even a high school education

Nursing homes: a review.

Recent developments, such as the passage of Medicare, have drawn attention to the need for evaluating existing posthospital extended care services, of which nursing homes are presently a major part. The author traces the evolution of the nursing home and reviews the literature describing nursing home services in the areas of general medical care, rehabilitation, psychiatric therapy, and psychiatric evaluation. The future of nursing homes, he concludes, depends in large part upon their ability to broaden and professionalize their functions beyond the provision of basic custodial care.

Medical auditing by scientific methods; illustrated by major female pelvic surgery.

The purpose of this article is to introduce scientific methods of medical auditing that can be used with common understanding by hospitals and doctors whose work is to be audited and by persons or agencies making audits. Methods for abstracting and classifying cases, criteria by which individual cases can be judged, and standards by which satisfactory performance can be measured are described and illustrated by actual experience. In the interest of brevity, the descriptions have been limited to a few kinds of female pelvic surgery, but similar methods for auditing other surgical operations and the diagnosis and treatment of various diseases will be described elsewhere. Medical audit is defined as the evaluation of medical care in retrospect through analysis of clinical records. It does not relieve the hospital staff of the daily necessity of supervising, educating, and assisting its members in providing good professional care; in fact, by its exposure