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MHA 707 CHAPTER 7 EXAM – 67 Q’S AND A’S
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MHA 707 CHAPTER 7 EXAM – 67 Q’S AND A’S
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MHA 707 CHAPTER 7 EXAM – 67 Q’S AND A’SThree evaluation criteria for health care systems accdg to ADAY* - -•Quality
•Equity
•Efficiency
-Microlevel* - -performance assessment is conducted with identifiable
health care providers, organizations, and treatments,
-macrolevel* - -Use global measures of health outcomes such as life
expectancy and mortality rates
-Health care quality is assessed in terms of based of Donabedian* - -
•Structure
•Process
•Outcomes
-•Structure* - -is meant to designate the conditions under which care is
provided
•Material resources, such as facilities and equipment
•Human resources, such as number and qualities of professional and support
personnel providing health care
-Process* - --Set of services provided
-Diagnosis, treatment, rehabilitation, prevention, and patient education
-Outcomes* - --End results people experience and care about
-Ensure that there are no other, unmeasured factors intervening to produce
poor outcomes, even with good process scores
•quality, equitable, and efficient health care?
-two types of outcomes - -•Population health outcomes
•Clinical (or health care-associated) outcomes
-Life expectancy in US - -81 for women,
76 for men
-Age-adjusted mortality rate* - -•Takes into account the population's age
distribution when calculating mortality rate
-Maternal mortality* - -Death of a woman while pregnant or within 42 days
of pregnancy termination, regardless of the length or site of the pregnancy
, -Time lost to premature death, also called years of potential life lost (YPLL)*
- -•Based on the difference between the actual age at death and the
expected age at death
-Higher YPLL* - -Earlier death rates
-Healthy life expectancy (HALE - -•Average number of years that a person
can expect to live in "full health" by taking into account years lived in less
than full health due to disease and/or injury
-Quality-adjusted life years (QALYs)* - -•emphasizes the individual's
perceived health status as the indicator of quality of life
-Disability-adjusted life years (DALYs)— - -combines mortality and disability
measures
-Years of healthy life (YHL - -combines perceived health and disability
activity limitation measures from the National Health Interview Survey
-Clinical outcomes - -scientifically valid methods, indicate the quality of the
health care received by patients
-Evidence-based medicine* - -conscientious, explicit, and judicious use of
current best evidence in making decisions about the care of individual
patients
-the first explicit steps in the process of evaluating health care quality—in a
facility, by a provider or a health care system - -Designing and conducting
clinical outcomes
-Levels of Evidence - -4
-Level II - -50% of recommendations
-Baker & Chassin - -Although the goal of medicine is to improve health
outcomes for patients, using outcome measures for accountability requires
extreme care. We must approach this task as rigorously as has been done
for process measures if we are going to identify and reward providers who
achieve the best outcomes and use measurement to drive quality
improvement
-Organizations with major roles in health care quality improvement - -
•Centers for Medicare & Medicaid Services (CMS)
•Agency for Healthcare Research and Quality (AHRQ)
•Centers for Disease Control and Prevention (CDC)
•National Institutes of Health (NIH)
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