RESUMEN
The health care industry is compelled to reduce costs while providing high-quality patient care. Outcomes analysis enables monitoring and maintenance of quality of care in our rapidly changing practice environment. Comprehensive outcomes research cannot occur, however, without a database incorporating practice-related data, interventions and components of care, and outcomes of care. The article reports the design and proposed implementation of an outcomes assessment infrastructure in a multifacility health maintenance organization in Northern California. The infrastructure integrates traditionally measured outcomes and cost data with nontraditional, nurse-influenced, health-related outcomes.
Asunto(s)
Sistemas Prepagos de Salud/normas , Investigación en Evaluación de Enfermería/métodos , Evaluación de Resultado en la Atención de Salud/organización & administración , California , Sistemas Prepagos de Salud/organización & administración , Equipos de Administración Institucional , Relaciones Interprofesionales , Modelos Organizacionales , Evaluación en Enfermería/organización & administraciónRESUMEN
Sixty patients undergoing cholecystectomy were studied and allocated at random to a control group and a treated group to whom physiotherapy instruction was given. Respiratory function tests were recorded pre-operatively and on the 2nd and 5th post-operative days. These showed no statistical difference in values pre-operatively, a statistically significant difference in value in both groups for all tests on the 2nd postoperative day, with maintenance of such reduced value for forced vital capacity (F.V.C) and peak flow (P.F.) in the control group on the 5th post-operative day.
Asunto(s)
Ejercicios Respiratorios , Cuidados Posoperatorios , Cuidados Preoperatorios , Colecistectomía/rehabilitación , Ensayos Clínicos como Asunto , Humanos , Educación del Paciente como Asunto , Pruebas de Función Respiratoria , AutocuidadoRESUMEN
The Federal Government has engaged in research and investigation of dental quality assurance and related questions of dental delivery and financing for nearly 3 decades. Despite this federal effort and other privately financed projects, there is no completely accepted consensus regarding the definition or scope of the term "quality assurance" as applied to dentistry. Although federally sponsored research has declined lately, the profession has many interested parties to satisfy: consumers, the Federal Government, third- and fourth-party purchasers, unions, and others. Continued attention to dental quality assurance by the profession and other parties is desirable to ensure continuation of high standards of professionalism and practice.
Asunto(s)
Atención Odontológica/normas , Gobierno , Garantía de la Calidad de Atención de Salud , Atención a la Salud , Atención Odontológica/legislación & jurisprudencia , Humanos , Legislación en Odontología/tendencias , Garantía de la Calidad de Atención de Salud/legislación & jurisprudencia , Calidad de la Atención de Salud/legislación & jurisprudencia , Estados UnidosRESUMEN
Federal support of health services delivery has been closely tied to social welfare and economic assistance legislation. Its underlying premise has been that health services should be provided by government only when individuals and families are unable to cope with health problems on their own. Dental care has never drawn a major share of health and welfare resources. It has been authorized in general terms by various statutes, but seldom have funds been earmarked specifically for dental services. Accordingly, the history of federal financing of dental services shows a gradual but progressive extension of services to populations and communities unable to obtain services on their own. Over time, a system of federal grants-in-aid has been built through which assistance is provided to state agencies or directly to communities or individuals. Table 3 provides a summary of the major programs. Before 1965, states received little federal support for dental services, except for funds provided through maternal and child health or crippled children's programs. Although Social Security authorized other public assistance funds that could be used for dental services, these were used principally to provide health services for the elderly. The relatively slow growth of federal dental programs accelerated during the Johnson and Nixon administrations. The explosion of health legislation during these years significantly broadened the federal role in providing health services to individuals and communities. Medicaid, the OEO programs, the health planning acts, migrant health, Appalachian Regional Development, Model Cities, and other statutes had significant impact on the accessibility and availability of dental services in poor, disadvantaged, rural, and otherwise underserved communities.(ABSTRACT TRUNCATED AT 250 WORDS)