This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ottensmeyer, D. J. Articles by Key, M. K. Search for Related Content PubMed Articles by Ottensmeyer, D. J. Articles by Key, M. K. Social Bookmarking                         What's this?

Assuring Quality in Proprietary Managed Care Systems

EQUICOR, Nashville, Tennessee 37203

Martha Kathryn Key, Ph.D.

EQUICOR, Nashville, Tennessee 37203

This paper defines quality assurance (QA) and dis cusses state-of-the art QA programs in managed care organizations today. Utilization management (UM) is distinguished from QA, although they are interre lated. While UM is process-oriented and focuses on efficiency and cost-effectiveness, QA is directed more to the result or outcome of medical care. The major abstracts in the transition from process to outcome- oriented QA are agreed upon standards of care and data systems. The medical profession would seem a logical candidate to develop these systems, but the profession has resisted such efforts, showing an ina bility to enforce true accountability. The impact of QA/UM on clinical decision-making is discussed, with implications for the profession of medicine.

American Journal of Medical Quality, Vol. 3, No. 3, 75-78 (1988)
DOI: 10.1177/0885713x8800300304


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?