Assessing the quality of primary care: the use and importance of reimbursement data.
Although inpatient quality assessment efforts have advanced greatly in recent years, similar growth has not yet been experienced in ambulatory care. However, given the growth of primary care and its role in managed care systems, the need for quality assessment innovations is great and the future looks promising. The authors describe their experience in developing such an innovation in an ambulatory care setting. The goal of this article is to identify and describe how secondary data--in particular, data from reimbursement systems--may be used to develop a primary care quality of care assessment system. This investigation highlights the importance of reimbursement data in developing clinically meaningful and practical models for quality assessment.
Longo
D R
DR
School of Medicine, University of Missouri-Columbia, USA.
Daugird
A J
AJ
Spencer
D C
DC
D000293:Adolescent; D000328:Adult; D003362:Cost-Benefit Analysis; D003628:Database Management Systems; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D008875:Middle Aged; D011314:Preventive Health Services / Q000191:economics; D011320:Primary Health Care / Q000191:economics*; D011785:Quality Assurance, Health Care / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics*