Estimating costs of quality improvement for outpatient healthcare organisations: a practical methodology.
BACKGROUND
Outpatient healthcare organisations worldwide participate in quality improvement (QI) programmes. Despite the importance of understanding the financial impact of such programmes, there are no established standard methods for empirically assessing QI programme costs and their consequences for small outpatient healthcare organisations.


OBJECTIVE
The costs and cost consequences were evaluated for a diabetes QI programme implemented throughout the USA in federally qualified community health centres. For five case study centres, survey instruments and methods for data analysis were developed.


RESULTS
Two types of cost/revenue were evaluated. Direct costs/revenues, such as personnel time, items purchased and grants received, were evaluated using self-administered surveys. Cost/revenue consequences, which were cost/revenue changes that may have occurred due to changes in patient utilisation or physician behaviour, were evaluated using electronic billing data. Other methods for evaluating cost/revenue consequences if electronic billing data are not available are also discussed.


CONCLUSIONS
This paper describes a practical taxonomy and method for assessing the costs and revenues of QI programmes for outpatient organisations. Results of such analyses will be useful for healthcare organisations implementing QI programmes and also for policy makers designing incentives for QI participation.
Brown
Sydney E S
SE
Section of General Internal Medicine and the Diabetes Research and Training Center, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.
Chin
Marshall H
MH
Huang
Elbert S
ES
D003151:Community Health Centers / Q000191:economics / Q000592:standards*; D003361:Cost Allocation / Q000379:methods; D003362:Cost-Benefit Analysis / Q000379:methods; D003920:Diabetes Mellitus / Q000628:therapy*; D005376:Financial Management; D017048:Health Care Costs / Q000145:classification*; D006284:Health Plan Implementation / Q000191:economics*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011050:Policy Making; D016730:Program Development / Q000191:economics; D017749:Total Quality Management / Q000191:economics*; D014481:United States
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