Use of Insurance Claims Data in Measuring Quality of Care

1990 ◽  
Vol 6 (2) ◽  
pp. 263-271 ◽  
Author(s):  
Kathleen N. Lohr
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Administrative Data ◽  
Claims Data ◽  
Outcome Analysis ◽  
Process Of Care ◽  
Service Information ◽  
Insurance Claims Data ◽  
Data Banks

AbstractThis article discusses data that might be used for measuring quality of care, for health care administrative purposes, and for tracking the use of technologies. The advantages and limitations of administrative data banks for research purposes and some process-of-care and outcome analysis are noted. Three important obstacles to their use—reliability of diagnosis and service information, unique patient identifiers, and provider identifiers—are discussed briefly.

Applying Insurance Claims Data to Assess Quality of Care: A Compilation of Potential Indicators

1990 ◽  
Vol 16 (12) ◽  
pp. 424-438 ◽  
Author(s):  
Jonathan P. Weiner ◽  
Neil R. Powe ◽  
Donald M. Steinwachs ◽  
Greg Dent
Keyword(s):  
Quality Of Care ◽  
Claims Data ◽  
Insurance Claims ◽  
Insurance Claims Data ◽  
Assess Quality

Patients' vs. Professionals' Perceptions of Quality of Care in Greek Public Hospitals

2015 ◽  
Vol 4 (3) ◽  
pp. 47-57
Author(s):  
Ioulia Andricopoulou ◽  
Eirini Margarita Toubeki ◽  
Foteini Gialama ◽  
Panagiotis Prezerakos ◽  
Nikolaos Avraam ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Professionals ◽  
Psychological Needs ◽  
Public Hospitals ◽  
Process Of Care ◽  
Great Satisfaction ◽  
Treatment Procedures ◽  
Gains And Losses

The aim of the study was to compare the views of health care professionals and patients on the quality of care in Greek public hospitals. Traditionally quality of health care was measured using only professional standards. However, in this study the authors tried to measure also patients' welfare, taking into account the expected gains and losses during the process of care. The study was conducted in hospitalized patients (N=313) and health care professionals (N=278 nurses and doctors) in three public hospitals of Attica. Data collection was conducted with the use of two structured and anonymous questionnaires. Main findings showed great satisfaction from the provided care expressed both from patients and health professionals especially in relation to information concerning their health status, pain assessment and the consent requested for treatment procedures. Both groups were dissatisfied by the assessment of social and psychological needs (of patients) and by the possibility of expressing patients' satisfaction or dissatisfaction from the quality of provided health care.

Problems of pathology related to the dermatovenerology field in the emergency hospital

2020 ◽  
pp. 45-52
Author(s):  
I. Barsukova ◽  
I. Bagretsova
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Emergency Care ◽  
Diagnostic Process ◽  
Emergency Hospital ◽  
New Models ◽  
Hospital Development

Development of a system for the delivery of emergency care in a hospital inevitably raises questions of its availability and quality. And, if the leading pathological syndrome which is a reason for hospitalization and posing a threat to the patient's life deserves priority attention, then the accompanying pathology often stays in the background. At the same time the accompanying pathology related to the field of dermatovenerology poses epidemiological threat. The aim of the study was to improve the organization of health care for patients with concomitant pathology related to dermatovenerology in an emergency hospital. Development of new models and principles of the organization of medical and diagnostic process, introduction of methods of express diagnostics is required; importance of a dermatovenerologist becomes obvious, it will increase the availability and quality of care for patients with dermatovenereological pathology in an emergency hospital.

Problems in the Health Care of Dying Old Men: Complaints by their Widows

1995 ◽  
Vol 31 (2) ◽  
pp. 121-141 ◽  
Author(s):  
Maria M. Talbott
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Medical Care ◽  
Health Care Professionals ◽  
Lack Of Control ◽  
Old Men

Complaints of older widows regarding their husbands' health care are investigated in this study. Sixty-four older widows were interviewed several years after their husbands' deaths. The deaths occurred in the early 1980s. Forty-six percent reported problems in the health care their husbands had received. Widows whose husbands had not known in advance that they were going to die were more likely to complain about their husbands' medical care than widows whose husbands had known in advance. Complaints were also related to the frequency of several symptoms of grief. The widows' complaints about their husbands' care focus on quality of care, perceived insensitivity on the part of health care professionals, lack of control over the death, and the organization of services.

scholarly journals The Patient Experience of Inpatient Care During the COVID-19 Pandemic: Exploring Patient Perceptions, Communication, and Quality of Care at a University Teaching Hospital in the United Kingdom

2021 ◽  
Vol 8 ◽  
pp. 237437352199774
Author(s):  
Thomas Key ◽  
Avadhut Kulkarni ◽  
Vikram Kandhari ◽  
Zayd Jawad ◽  
Angela Hughes ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Patient Experience ◽  
Health Care Professionals ◽  
Disease Transmission ◽  
Inpatient Care ◽  
University Teaching ◽  
Health Board ◽  
Experience Of Care

The coronavirus disease 2019 (COVID-19) pandemic has necessitated many rapid changes in the provision and delivery of health care in hospital. This study aimed to explore the patient experience of inpatient care during COVID-19 pandemic. An electronic questionnaire was designed and distributed to inpatients treated at a large University Health Board over a 6-week period. It focused on hospital inpatients’ experience of being cared for by health care professionals wearing personal protective equipment (PPE), explored communication, and patients’ perceptions of the quality of care. A total of 704 patients completed the survey. Results demonstrated that patients believe PPE is important to protect the health of both patients and staff and does not negatively impact on their care. In spite of routine use of PPE, patients were still able to identify and communicate with staff. Although visiting restrictions were enforced to limit disease transmission, patients maintained contact with their relatives by using various electronic forms of communication. Overall, patients rated the quality of care they received at 9/10. This single-center study demonstrates a positive patient experience of care at an unprecedented time.

scholarly journals Patient’s Satisfaction With Quality of Care at a National Health Insurance Clinic at a Tertiary Center, South-South Nigeria

2021 ◽  
Vol 8 ◽  
pp. 237437352098147
Author(s):  
Temitope Esther Olamuyiwa ◽  
Foluke Olukemi Adeniji
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Bivariate Analysis ◽  
P Value ◽  
Tertiary Center

Introduction: Patient satisfaction is a commonly used indicator for measuring the quality of health care. This study assessed patients’ satisfaction with the quality of care at the National Health Insurance Scheme (NHIS) clinic in a tertiary facility. Methods: It was a descriptive cross-sectional study in which 379 systematically selected participants completed an interviewer-administered, semi-structured questionnaire. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 23. Bivariate analysis was performed using Pearson χ2 with a P value set at ≤ .05. Results: The study found out that about half (193, 50.9%) of the respondents were satisfied with the availability of structure. Patients were not satisfied with waiting time in the medical records, account, laboratory, and pharmacy sections. Overall, 286 (75.5%) of the respondents were satisfied with the outcome of health care provided at the NHIS clinic. A statistically significant association ( P = .00) was observed between treatment outcome and patient satisfaction. Conclusion: There is a need to address structural deficiencies and time management at the clinic.

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