Quality of care and performance-based reimbursement: The contemporary landscape and implications for urologists

ObjectivesExternal inspections are widely used to improve the quality of care. The effects of inspections remain unclear and little is known about how they may work. We conducted a narrative synthesis of research literature to identify mediators of change in healthcare organisations subject to external inspections.MethodsWe performed a literature search (1980–January 2020) to identify empirical studies addressing change in healthcare organisations subject to external inspection. Guided by the Consolidated Framework for Implementation Research, we performed a narrative synthesis to identify mediators of change.ResultsWe included 95 studies. Accreditation was the most frequent type of inspection (n=68), followed by statutory inspections (n=19), and external peer review (n=9). Our findings suggest that the regulatory context in which the inspections take place affect how they are acted on by those being inspected. The way inspections are conducted seem to be critical for how the inspection findings are perceived and followed up. Inspections can engage and involve staff, facilitate leader engagement, improve communication and enable the creation of new networks for reflection on clinical practice. Inspections can contribute to creating an awareness of the inspected organisation’s current practice and performance gaps, and a commitment to change. Moreover, they can contribute to facilitating the planning and implementation of change, as well as self-evaluation and the use of data to evaluate performance.ConclusionsExternal inspections can affect different mediators of organisational change. The way and to what extent they do depend on a range of factors related to the outer setting, the way inspections are conducted and how they are perceived and acted on by the inspected organisation. To improve the quality of care, the organisational change processes need to involve and impact the way care is delivered to the patients.

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Enhancing Research on Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2006.06.7207 ◽

2006 ◽

Vol 24 (32) ◽

pp. 5149-5153 ◽

Cited By ~ 57

Author(s):

John Z. Ayanian ◽

Paul B. Jacobsen

Keyword(s):

Quality Of Life ◽

Quality Of Care ◽

Cancer Survivors ◽

Cancer Registries ◽

The United States ◽

Institute Of Medicine ◽

Survivorship Care ◽

Care Plans ◽

And Performance

The United States devotes substantial resources to understanding the etiologies of cancer and improving treatments, but much less research has focused on the needs of cancer survivors after they have completed active treatment. This article augments findings from the Institute of Medicine about cancer survivorship research and ways to enhance quality of life and quality of care. Studies of cancer survivors should focus on mechanisms and risk factors for impaired quality of life and evaluate interventions to improve this domain. Research to improve quality of care should concentrate on survivorship care plans, surveillance tests, respective roles of primary and specialty care, and performance measures related to survivorship care. Opportunities to expand research on cancer survivors include clinical trials, large cohort studies, cancer registries, and national surveys. Research to understand the needs of cancer survivors will provide a foundation for effective programs to meet these needs.

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Informal Payments and Performance in the Health Care Sector: Possible Relationships in a Sub-National Perspective

International Journal of Business and Management ◽

10.5539/ijbm.v15n3p126 ◽

2020 ◽

Vol 15 (3) ◽

pp. 126

Author(s):

Elisabetta Reginato ◽

Isabella Fadda ◽

Paola Paglietti ◽

Aldo Pavan

Keyword(s):

Health Care ◽

Quality Of Care ◽

Health Status ◽

Access To Care ◽

Negative Influence ◽

Informal Payments ◽

Regional Health Care ◽

And Performance ◽

Petty Corruption

The paper explores the relationship between corruption and performance dimensions of the Italian regional health care systems (RHSs). In Europe, Italy shows the widest sub-national in performance and corruption levels. The research focuses on petty corruption in health care. So-called informal payments are the most common form and were measured using data from the European Quality of Government Index Survey. The performance of Italian RHSs was assessed using key indicators divided into three analytical dimensions: health status; access to care; and quality of care. OECD Health Data was used as source data for health status and access to care. As a proxy for quality of care, the study used avoidable mortality, with data drawn from the Italian National Institute of Statistics (ISTAT). The study formulated a research hypothesises that petty corruption has a negative influence on RHS performance. The findings showed considerable regional differences. The results did not confirm the research hypotheses. However, informal payments did show an adverse effect on renunciations to specialist medical examinations due to costs.

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Information Technology–Assisted Treatment Planning and Performance Assessment for Severe Thalassemia Care in Low- and Middle-Income Countries: Observational Study (Preprint)

10.2196/preprints.9291 ◽

2017 ◽

Author(s):

Rajat Kumar Agarwal ◽

Amit Sedai ◽

Kumari Ankita ◽

Lalith Parmar ◽

Rakesh Dhanya ◽

...

Keyword(s):

Quality Of Care ◽

Performance Assessment ◽

Spleen Size ◽

Liver Size ◽

Middle Income ◽

Middle Income Countries ◽

Effective Delivery ◽

And Performance ◽

The Impact

BACKGROUND Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally. OBJECTIVE The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC. METHODS A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed. RESULTS Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12). CONCLUSIONS Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC.

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