Mortality Rates as a Quality Indicator: A Simple Answer to a Complex Question

1988 ◽  
Vol 9 (7) ◽  
pp. 330-332 ◽  
Author(s):  
William B. Crede ◽  
Walter J. Hierholzer
Keyword(s):  
Health Care ◽  
Performance Indicator ◽  
Care Delivery ◽  
Mortality Rates ◽  
Current Data ◽  
Face Validity ◽  
Mortality Data ◽  
Specific Mortality ◽  
Health Care Delivery Systems

As the consumers and regulators of health care have become more concerned with quality of delivered services, interest has focused on hospital- and physician-specific mortality rates as an index of quality. Mortality rates have several characteristics that promote their use as a performance indicator. The numerator, death, is generally (but perhaps incorrectly) accepted as an adverse outcome of health care. Death is thought to be easily measured, and is recorded in several locations, including the medical record abstract and death certificates, where the information is accessible without provider consent. The denominator, persons or patients, is also available from several public sources. The desirability of mortality data is further enhanced by the wide variety of statistical methods to manipulate and compare rates and proportions. The conceptual validity of mortality rates as reflecting quality is supported by a long tradition of using mortality rates at the “macro” level to compare the quality of national health care delivery systems (eg, infant mortality rates) and at the “micro” level to compare the outcome of different therapies (eg, thrombolytics for acute myocardial infarction). However, despite face validity, ease of measurement, and widespread acceptance in other areas, hospital-specific mortality rates, as calculated from current data sources, have a variety of potential problems.This article will explore the clinical, administrative, and information-based difficulties in using mortality rates as an indicator of the quality of medical care delivered by specific hospitals or physicians.

scholarly journals Nurse competencies for health promotion in the mental health context

2012 ◽  
Vol 25 (spe2) ◽  
pp. 157-163 ◽  
Author(s):  
Maria Isis Freire de Aguiar ◽  
Hélder de Pádua Lima ◽  
Violante Augusta Batista Braga ◽  
Priscila de Souza Aquino ◽  
Ana Karina Bezerra Pinheiro ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Promotion ◽  
Professional Competence ◽  
Care Delivery ◽  
Care Practice ◽  
Health Care Practice ◽  
Patient Health ◽  
Health Care Delivery Systems

OBJECTIVE: To identify the competencies of nurses to health promotion in psychiatric and mental health context. METHODS: Integrative review of literature performed through search using the keywords: "mental health" and "professional competence", in the databases SciELO, LILACS, CINAHL, PubMed, Scopus and Cochrane, in the period of 2003 to 2011. 215 studies were identified, of these, six followed the inclusion criteria. RESULTS: Based on the National Panel for Psychiatric Mental Health NP Competencies, the competencies were identified on the evaluated studies: Monitoring and ensuring the quality of health care practice, management of patient health/illness status, cultural competence, managing and negotiating health care delivery systems, the nurse practitioner-patient relationship. CONCLUSION: The studies analysis evidenced the need for education and training so that nurses may develop the competencies of health promotion in diverse psychiatric care and mental health contexts, in order to broaden knowledge and skills.

scholarly journals Current developments in delivering customized care: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Etienne Minvielle ◽  
Aude Fourcade ◽  
Thomas Ricketts ◽  
Mathias Waelli
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Delivery ◽  
Scoping Review ◽  
Care Delivery ◽  
Patient Characteristics ◽  
Delivery Systems ◽  
Segmentation Analysis ◽  
Health Care Delivery Systems

Abstract Background In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. Methods Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included “care customization”, “personalized service and health care”, individualized care” and “targeting population” in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. Results We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. Conclusions There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.

Caring for Patients, Profession, and World The Social Activism of Lavinia Lloyd Dock

1997 ◽  
Vol 1 (1) ◽  
pp. 12-17
Author(s):  
Mary Ramos,
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Social Activism ◽  
Human Interaction ◽  
Nursing History ◽  
Individual Level ◽  
Nursing Leaders ◽  
The Social ◽  
Health Care Delivery Systems

Caring as a concept is widely discussed and debated within nursing. It is typically understood conceptually as a quality of a human interaction, usually the nurse’s interaction with a patient, client, family, or group (Gaut & Boykin, 1994; Eriksson, 1992; Leininger, 1980, 1984; Watson, 1985). Caring is culturally bound, laden with positive value. But common understanding may limit the scope of this foundational concept, for nursing, nurses, patients, and health care exist in societal context. As roles in health care are expanding and changing in light of health care reform, our professional adaptation is ideally based on caring relationships with individuals and also with institutions, populations and health care delivery systems. As with caring on an individual level, individual nurses have left an example of caring for society on a larger scale, literally a global level. Lavinia Lloyd Dock is an obvious example of international caring. This diminutive woman had a voice and intellect that has survived.Nursing history is replete with stories of caring nurses, angels of mercy, somehow with a strength of character unreconciled to the ‘gentle spirit of Victorian womanhood.’ The political skill of nursing leaders a hundred years ago cannot be underestimated. The work of establishing nursing as a profession took untold tact, manipulation, pointed subservience, and an ability to withstand frustration at the hand of individuals, institutions, and a culture that held rather circumscribed roles and expectations for women. Certain women attacked the system in a direct fashion; Lavinia Dock was one of those.

The Future of Health Care in South Korea and the UK

2006 ◽  
Vol 5 (3) ◽  
pp. 375-385 ◽  
Author(s):  
Bob Matthews ◽  
Yoonsoon Jung
Keyword(s):  
Health Care ◽  
South Korea ◽  
Care Delivery ◽  
Health Care Systems ◽  
Public Provision ◽  
Capitalist System ◽  
Private Provision ◽  
Care Systems ◽  
Health Care Delivery Systems ◽  
The Uk

This paper discusses and compares the origin and development of the health care systems of South Korea and the UK from the end of WW2 and endeavours to compare outcomes. The paper emphasises the importance of war as a stimulus to the development of national health services in both countries and argues that there is convergence between the UK's nationalised NHS and South Korea's US-modelled capitalist system. Overall, we conclude that there is a possibility not only that the financing and nature of the Korean and UK health care delivery systems may show convergence, but it is not impossible that they will ‘change places’ with the UK system dominated by private provision and South Korea's by public provision.

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