title: Systems versus performance problems: a peer review organization's perspective.
abstract: An analysis of Ohio's Medicare data base by the state's Peer Review Organization, using the most common diagnosis-related group in the Medicare population (heart failure and shock), from January 1, 1989 to January 1, 1991, identified 72 cases with confirmed quality-of-care problems. The analysis was performed to determine whether the majority of quality-of-care problems are related to systems or performance deficiencies. Study results indicated that health care workers are being inappropriately blamed for problems that are inherent in the health care system--74% of problems were related to inefficiencies in the health care delivery system, and 26% were determined to reflect performance problems.
authors.affiliation: Peer Review Systems, Inc, Columbus, Ohio 43231-7900.
authors.forename: J H
authors.initials: JH
authors.lastname: Brooks
authors.forename: K K
authors.initials: KK
authors.lastname: Renz
authors.forename: S L
authors.initials: SL
authors.lastname: Richardson
authors.forename: S
authors.initials: S
authors.lastname: White
authors.forename: J
authors.initials: J
authors.lastname: Hosey
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004526:Efficiency; D006302:Health Services Research; D006333:Heart Failure / Q000628:therapy; D006761:Hospitals / Q000592:standards; D006801:Humans; D008505:Medical Staff, Hospital / Q000592:standards; D006278:Medicare; D009820:Ohio; D011366:Professional Review Organizations / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D012769:Shock / Q000628:therapy; D013597:Systems Analysis; D014481:United States