Preview

Acta Biomedica Scientifica

Advanced search

Assessing the quality of medical care and developing the ratings of health services: experience of using Medicare program in the USA

https://doi.org/10.12737/23394

Abstract

To provide patient's security is the main goal in some spheres of health care, that is why methods of statistical monitoring were developed to detect abnormalities in the course of medical work quickly and confidentially. This includes, for example, excessive intervention even without further damage to a patient's safety. Therefore, it is very important to determine whether the risk to a patient's life exists or how abnormal the situation is. At the present moment health care in Russia has already passed the initial stage of formation of ratings to assess the quality of medical care services. Almost all regions of the Russian Federation have their own ratings. The question is how objectively they reflect the quality of medical services. The article presents main features to assess the quality of health care to rate medical organizations on the example of state program Medicare (USA) in order to compare them with the ones used in Russian ratings.

About the Author

N. S. Grigorieva
N.S. Grigorieva Lomonosov Moscow State University
Russian Federation


References

1. Авдеева М.В., Ващенков В.В., Лучкевич В.С., Бар-каева В.А. Рейтингование медицинских организаций как способ повышения эффективности здравоохранения: история вопроса и перспективы использования // Социальные аспекты здоровья населения. - 2015. -Т. 44, № 15. - С. 2

2. Азаров А.В. Рейтинги медицинских организаций: подходы к формированию // Здравоохранение. -2015. - № 7. - С. 54-61

3. Алексеева Н.Ю., Пчела Л.П., Макаров С.В. Исследование удовлетворённости населения качеством медицинской помощи в условиях реформирования здравоохранения // Бюл. ВСНЦ СО РАМН. - 2011. -№ 1. - С. 259-262

4. Григорьева Н.С. Мониторинг качества работы медицинских организаций: методологический комментарий // Государственное управление. Электронный вестник. - 2015. - Вып. 51

5. Любарская М.А., Клунко Н.С. Оценка качества стратегического целеполагания на основе анализа системы показателей развития фармацевтической отрасли Российской Федерации // Бюл. ВСНЦ СО РАМН. - 2014. - № 4. - С. 63-68

6. Михайлова Н.В. Методология обеспечения и управления качеством медицинской помощи в соответствии с международными стандартами ИСО серии 9000 // Вестник Росздравнадзора. - 2010. - № 3. - C. 19-27

7. Тарасенко Е.А. Зарубежный опыт выбора показателей качества медицинской помощи для построения рейтингов медицинских организаций: уроки для России // Социальные аспекты здоровья населения (электронный научный журнал). - 2013. -№ 34 (6). - Режим доступа: http://vestnik.mednet.ru/content/view/520/lang?ru

8. Agency for Healthcare Research and Quality (2013). HCUP statistical brief, 160.

9. Batalden P.B., Buchanan E.D. (1989). Industrial models of quality improvement. In: Providing quality care: the challenge to clinicians (Goldfield N, Nash DB, eds.), 133-159.

10. Berwick D.M. (1989). Sounding board. continuous improvement as an ideal in health care. N. Engl. J. Med., (320), 53-56.

11. Bradley R. (2008). Comment - defining health insurance affordability: Unobserved heterogeneity matters. J. Health Econ., (27), 1129-1140.

12. Consumer reports hospital ratings. Available at: http://www.consumerreports.org/health/doctors-hospitals/hospital-ratings.htm.

13. Donabedian A. (1966). Evaluating the quality of medical care. Milbank Memorial Fund Quarterly, 44 (3), 166-206.

14. Donabedian A. (1980, 1982, 1984). Explorations in quality assessment and monitoring, (I-III).

15. Donabedian A. (1988a). Quality assessment and assurance: unity of purpose, diversity of means. Inquiry, (25), 173-192.

16. Donabedian A. (1988b). The quality of care. How can it be assessed? J. Am. Med. Ass., (260), 1743-1748.

17. Medicare - statistics & facts. Available at: http://www.statista.com/topics/1167/medicare.

18. Physician hospital outpatient analysis (2013). Available at: http://www.comparionanalytics.com (accessed 2013 Jun 26).

19. Pope DG (2008). Reacting to rankings: Evidence from "America's Best Hospitals". J. Health Econ., (28), 1154-1165.

20. Torio CM, Andrews RM (2013). National inpatient hospital costs. The most expensive conditions by payer.

21. US news and world report rating (2013). Available at: http://www.usnews.com/pubfiles/7-17AdultMethReport2012_Final.pdf (accessed 2013 Jun 26).

22. US news: Best hospitals 2013-14 Medicare. Available at: http://health.usnews.com.

23. World Health Organization (2008). Performance measurement for health system improvement: experiences, challenges and prospects.


Review

For citations:


Grigorieva N.S. Assessing the quality of medical care and developing the ratings of health services: experience of using Medicare program in the USA. Acta Biomedica Scientifica. 2016;1(5):71-76. (In Russ.) https://doi.org/10.12737/23394

Views: 711


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2541-9420 (Print)
ISSN 2587-9596 (Online)