Medicare New Directions in Quality Assurance Proceedings (1991) / Chapter Skim
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22. An Administration Response to the Institute of Medicine Report from the Agency for Health Care Policy and Research
22. An Administration Response to the Institute of Medicine Report from the Agency for Health Care Policy and Research
Pages 174-178
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From page 174... ...
The agency replaces the former National Center for Health Services Research and Health Care Technology Assessment, which had traditionally been the primary funder of investigator-initiated health services research. Many of the studies of quality assurance noted in the IOM report were funded by the center.
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From page 175... ...
We view the creation of the agency and its expanded mission as an opportunity to make quality assurance an important component of the Public Health Service agenda and to continue collaborative activities with the Health Care Financing Administration, other public and private organizations, and professional and consumer groups. The analyses and recommendations of the IOM report will be very instructive as we go about these tasks.
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From page 176... ...
About 26 other research projects address other issues pertaining to outcomes and effectiveness, and we expect these activities to grow over time. Facilitating the development of clinical practice guidelines, standards, and performance measures is the responsibility of our Office of the Forum for Quality and Effectiveness in Health Care.
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From page 177... ...
We plan an increased emphasis on applied or operational research aimed at developing tools and methods for ongoing quality assurance and evaluating their effects. Topics that warrant investigation include the relative effects of generic quality screens versus condition-specific review criteria; the integration of treatment information and claims data across multiple providers, payers, and health care settings; the effects of incentives versus sanctions in changing provider behavior; the roles of internal continuous improvement models of quality assurance versus external monitoring in sustaining changes in overall levels of quality over time; and the utility of the continuous improvement model in dealing with clinical problems encountered in ordinary medical practice, such as poor physician decisionmaking.
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From page 178... ...
We are interested in supporting activities such as demonstrations and evaluations of the effects of tort reform on medical liability claims, studies of the results of medical effectiveness research as they may pertain to medical liability, and systematic analyses of claims for medical negligence to determine the types of events that lead to bad outcomes, the settings in which they occur, and the circumstances surrounding their occurrence. SUMMARY To summarize, the Agency for Health Care Policy and Research has already charted a course intended to expand the knowledge base about the outcomes, effectiveness, and appropriateness of health care and of systems assessing and improving the quality of care.
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