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Titolo:
The clinical guideline process within a managed care organization
Autore:
Richman, R; Lancaster, DR;
Indirizzi:
Tufts Hlth Plan, Qual Improvement & Womens Hlth, Waltham, MA 02454 USA Tufts Hlth Plan Waltham MA USA 02454 & Womens Hlth, Waltham, MA 02454 USA
Titolo Testata:
INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE
fascicolo: 4, volume: 16, anno: 2000,
pagine: 1061 - 1076
SICI:
0266-4623(200023)16:4<1061:TCGPWA>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
DISEASE MANAGEMENT; DECISION-SUPPORT; STANDARDS; OUTCOMES; QUALITY;
Keywords:
practice guidelines; managed care programs; quality indicators; health care; program evaluation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Richman, R Tufts Hlth Plan, Qual Improvement & Womens Hlth, 333 Wyman St,POB 9112, Waltham, MA 02454 USA Tufts Hlth Plan 333 Wyman St,POB 9112 Waltham MA USA 02454 USA
Citazione:
R. Richman e D.R. Lancaster, "The clinical guideline process within a managed care organization", INT J TE A, 16(4), 2000, pp. 1061-1076

Abstract

Clinical practice guidelines have been available to clinicians for almost two decades, but the consistency of their implementation in practice remains highly variable. This paper describes the various processes and mechanisms used by one managed care organization to develop clinical guidelines and promote their adoption. Some of these mechanisms include provision of individual physician report cards, financial incentives, and various documentation tools that serve as reminders of guideline recommendations and provide an easy format to document recommended services. There have been measurement challenges in evaluating the effectiveness of selected interventions designed to enhance guideline compliance. Most of these challenges relate to reliability and validity concerns regarding the three primary data sources used in the evaluation process: medical records, administrative claims data, and member survey data. Some of the interventions the health plan has implemented to address these measurement challenges include using hybrid methods of data collection and developing collaborativepartnerships with outside organizations to enhance the accuracy and completeness of the available data. Outcomes of these efforts are described, as are physician response and recommendations for future enhancement of practice guidelines.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 11/07/20 alle ore 15:51:35