Module Components

• Overview
• Assignments

Topics

• Quality of Health Care
• Cost of Health Care
• What is Costing SO MUCH??

Nurs 690 Managerial Health Finance

Module 4: Quality and Cost of Health Care

Quality in health care

What Is Quality?

The Institute of Medicine defines health care quality as "the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge."

Quality Domains:

Safety. Relates to actual or potential bodily harm.

Timeliness. Relates to obtaining needed care while minimizing delays.

Effectiveness. Relates to providing care processes and achieving outcomes as supported by scientific evidence.

Efficiency. Relates to maximizing the quality of a comparable unit of health care delivered or unit of health benefit achieved for a given unit of health care resources used.

Equity. Relates to providing health care of equal quality to those who may differ in personal characteristics other than their clinical condition or preferences for care.

Patient centeredness. Relates to meeting patients' needs and preferences and providing education and support.

Sources of Information on Defining Quality

The National Quality Forum (NQF) is one of the many organizations working to improve the quality of healthcare in the U.S. The quality of the healthcare that Americans receive varies greatly across social, economic, and geographic boundaries. Recent studies have indicated that American adults receive recommended care only about 55 percent of the time; that disparities exist in the way care is delivered to racial and ethnic minorities; and that 30 percent of healthcare spending is wasteful and produces no value to the patient.

Health Care Quality. Keeping patients safe in health care settings is fundamental to achieving high-quality health care for all Americans. Our current initiatives aim to increase patient safety through prevention strategies focused on adverse drug events and health care-associated infections.

The National Committee for Quality Assurance (NCQA) exists to improve the quality of health care. We work for better health care, better choices and better health.