scholarly journals The Effects of Quality of Care on Costs: A Conceptual Framework

2013 ◽  
Vol 91 (2) ◽  
pp. 316-353 ◽  
Author(s):  
TERYL K. NUCKOLS ◽  
JOSÉ J. ESCARCE ◽  
STEVEN M. ASCH
2019 ◽  
Vol 5 (2-3) ◽  
pp. 92-100
Author(s):  
Joseph S Salama ◽  
Alex Lee ◽  
Ashkan Afshin

Healthcare innovation is becoming a popular but poorly defined option for those who are seeking new ways of reducing costs while also improving the quality of care. The process of innovating in healthcare delivery can be improved by identifying and understanding the unmet needs of patients and providers. We conducted two systematic literature reviews to identify the needs of these stakeholders throughout healthcare delivery and developed a conceptual framework for innovating in healthcare. Our results reveal tension between patients’ and providers’ preferences across three major categories—treatment and outcomes, process of care and structure of care. Therefore, innovating in healthcare may be better understood as addressing the unmet needs of each stakeholder by easing or eliminating tensions between stakeholders. This conceptual framework may serve as a useful instrument for health policymakers, payers and innovators to alike make better decisions as they invest in healthcare innovations.


2013 ◽  
Vol 21 (7) ◽  
pp. 774-793 ◽  
Author(s):  
Esther E Kuis ◽  
Gijs Hesselink ◽  
Anne Goossensen

Background: Ethics-of-care theories contain important notions regarding the quality of care; however, until now, concrete translations of the insights into instruments are lacking. This may be a result of the completely different type of epistemology, theories and concepts used in the field of quality of care research. Objectives: Both the fields of ‘ethics of care’ and ‘quality of care’ aim for improvement of care; therefore; insights could possibly meet by focusing on the following question: How could ethics-of-care theories contribute to better quality in care at a measurement level? This study reviews existing instruments with the aim of bridging this gap and examines the evidence of their psychometric properties, feasibility and responsiveness. Research design: A systematic search of the literature was undertaken using multiple electronic databases covering January 1990 through May 2012. Method and findings: Of the 3427 unique references identified, 55 studies describing 40 instruments were selected. Using a conceptual framework, an attempt was made to distinguish between related concepts and to group available instruments measuring different types of concepts. A total of 13 instruments that reflect essential aspects of ethics-of-care theory were studied in greater detail, and a quality assessment was conducted. Conclusion: Three promising qualitative instruments were found, which follow the logic of the patient and take their specific context into account.


2020 ◽  
Vol 25 (4) ◽  
pp. 319-334
Author(s):  
Brahim Zaadoud ◽  
Youness Chbab ◽  
Aziz Chaouch

PurposeThe purpose of this article is to analyze and compare between the frameworks of performance measurement in primary health care in the world. The subject of search is to compare if the frameworks of performance measurement in primary health care have an influence on performances of health centers.Design/methodology/approachWe conducted a systematic review of the literature to (1) identify the conceptual framework for measuring quality management systems, (2) assess the effects of conceptual framework on quality improvement and quality of care outcomes. We opted for the frameworks that are more cited in the literature and we analyzed and compared between these frameworks.FindingsEight dimensions were identified for assessing performance in Primary Health Care Facilities “PHCF” in more than 50% frameworks: Effectiveness, Safety, Accessibility, Equity, Efficiency, Acceptability, Patient Centeredness and Timeliness.Research limitations/implicationsThe limits of this study can be represented by the following elements: (1) lack of exhaustiveness with regard to the current Frameworks. (2) The evaluation of reliability and validity of the qualitative studies remains difficult to appreciate. (3) Most of the evaluation tools of the primary health care are not validated yet. (4) The difference in performance levels between countries, especially for the developed countries and the multitude of the frames of measure of performance, limits the comparability of the results.Practical implicationsThis study provides a conceptual and descriptive literature on the different conceptual frameworks for performance measurement in primary health care, and a practical and useful tool for comparison between the different conceptual frameworks. Several organisations of accreditation or certification introduced, developed, incorporated and checked the indicators of clinical quality in the organizations of health care. Some studies revealed links with the governance, the access, the continuity, the coordination, the efficiency and the strength primary care (Dionne Kringos, 2018). Improvements in the quality of care have been observed in the results of accreditation and certification bodies regarding hospital infection control infrastructure, organization and performance.Originality/valueEven if the links are not established within the framework of a scientific research, quality approaches are generally recognized as an essential tool to help establishments to improve the quality and the safety of the patients. Until now, it is not still common to make evaluation of the quality of care in the “PHCF” to obtain the relevant information. The necessity of having performance measurement tools, which puts in coherence the piloting of the operational level with the strategy, to integrate the organizational objectives into the measures of operational performances and make estimate its structures towards a real management by the quality.


1992 ◽  
Vol 7 (4) ◽  
pp. 271-286 ◽  
Author(s):  
Revital Gross ◽  
Jochanan Benbassat ◽  
Nurit Nirel ◽  
Miriam Cohen

2021 ◽  
Vol 23 (2) ◽  
pp. 275-293
Author(s):  
B. Zaadoud ◽  
Y. Chbab ◽  
A. Chaouch

Object: The purpose of this article is to analyse and compare the frameworks of performance measurement in primary health care in the world. The objective is to determine whether the frameworks of performance measurement in primary health care have an influence on the performance of health centres. Method: We conducted a systematic review of the literature to: (a) identify a conceptual framework for measuring quality management systems; and (b) assess the effects of the conceptual framework on quality improvement and quality of care outcomes. We chose frameworks highly cited in the literature and analysed and compared these frameworks. Results: Eight dimensions were identified for assessing performance in primary health care facilities (PHCFs) in more than 50% frameworks: effectiveness, safety, accessibility, equity, efficiency, acceptability, patient-centredness and timeliness. Conclusion: Even if the links are not established within the framework of a scientific research, quality approaches are generally recognised as an essential tool to help establishments improve their quality of care and the safety of their patients. Until now, the evaluation of the quality of care in the 'PHCF' is not yet in place, a blatant need for performance measurement tools, relevant information, coherence between the operational and strategic levels, integration of organizational objectives in the measurement of performance in order to direct the structures towards a true management by quality..


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