Objective: To identify common features of primary care clinics that have successfully achieved improvement in chronic disease care. Methods: We analyzed seven primary care practices that have achieved significant improvement in chronic disease care provided to adults with diabetes mellitus,...

If the disease management industry succeeds in producing effective solutions to many of the problems besetting today's healthcare delivery systems (such as misalignment of financial and care incentives, poor customer service, failure to provide useful preventative care, and a dearth of empirical...

Episodes of care provide a clinically meaningful unit of analysis for measuring both the cost and quality of patient care. Many health plans are currently using episode of care grouping software in cost-focused provider profiling applications. These profiles compare the cost for one provider to...

There are 3 demand sources in healthcare systems: the patient, provider and payor. Patient-determined demand is characterised as `random access' and emotionally charged. Provider-determined demand occurs within working environments that do not inherently support integration activities....

Objectives: To compare the experience of one managed care organization (MCO) [Anthem Blue Cross and Blue Shield Midwest Region] to the experience of a reference group of 15 other MCOs participating in a study designed to test the usefulness of outcomes management information in developing and...

Over the past 50 years the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has relied primarily on an assessment of standards compliance to make judgments about the capability of a healthcare organization to provide good quality care. Over the last decade, the focus has...

Health outcomes measurement has become increasingly important in the care of patients with end-stage renal disease (ESRD). Interest has been stimulated by the relatively poor outcomes of patients with ESRD, variations in the process of care, the high costs of ESRD care, and the development of...

Implementation of disease management programmes within an integrated delivery system (IDS) requires a multipronged approach utilising education, process changes, tools and communication to overcome barriers. Implementation efforts should be directed toward every member of the staff who comes in...

Healthcare professionals are increasingly held accountable for the standards of care that they provide. The focus of control for this accountability can be either internal or external activity to the professional body and can use implicit or explicit quality assessment techniques. The science of...

Although process measures of care have traditionally been used to assess the quality of healthcare, there is little evidence, for the majority of healthcare activities, to support a clear relationship between processes of care and resulting health gains. Outcomes monitoring is increasingly being...