HCM 214-224

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Questions and Answers

What was the critical impact of the Flexner Report of 1910 on the health care field?

It led to the widespread use of electronic data capture in health assessments

It raised public awareness about the importance of health care organizations

It introduced advanced computing capabilities for health system evaluations

It initiated rigorous scientific assessments of health care performance (correct)

How did the availability of electronic computing capacity in the 1970s impact health systems assessments?

It contributed to the decentralization of health care systems

It led to the development of advanced medical imaging techniques

It facilitated the widespread adoption of telemedicine in health care

It enabled assessments to move from small, time-consuming studies to current evaluations based on 'big health data' (correct)

Why is it essential for health care professionals to understand the assessment process of health system performance?

They are primarily responsible for funding health system assessments

They develop advanced computing capabilities for health system evaluations

They provide regulatory oversight for health care organizations

They increasingly contribute to the process of assessing and improving system performance (correct)

What is the basis of confidence and support that health care organizations need from individuals and institutions?

Satisfactory performance Signup and view all the answers

What prompted medicine and the health care field to move toward rigorous scientific assessments?

The Flexner Report of 1910 Signup and view all the answers

How have today's performance assessments improved compared to the past?

They are comprehensive and timely compared with the past Signup and view all the answers

What is HALE a measure of?

Combining length and quality of life into a single estimate Signup and view all the answers

Which of the following is NOT a health-adjusted life expectancy measure mentioned in the text?

LEAPYs Signup and view all the answers

In 2013, what was the HALE at birth for US females?

71 years Signup and view all the answers

Where did US men rank in Years of Potential Life Lost (YPLL) in comparison to other countries?

6th highest Signup and view all the answers

What was the Infant Mortality Rate (IMR) rank for the US compared to other countries?

3rd highest Signup and view all the answers

Which country had the highest age-standardized DALY per 100,000 population for all causes of death in 2012?

United States Signup and view all the answers

What factors can influence population health outcome measures according to the text?

Factors outside the healthcare system such as poverty, diet, exercise, substance use, environmental factors, and social policies Signup and view all the answers

What measure reflects the health care system but is also influenced by factors outside it?

"Population health outcome measures" Signup and view all the answers

Which of the following is NOT one of Aday et al.'s evaluation criteria for health care system performance?

Accessibility Signup and view all the answers

At the microlevel, what is a potential measure for evaluating the quality of care for cataract patients?

Postsurgical complications Signup and view all the answers

Which of the following is an example of a structure-oriented question in Donabedian's model for assessing health care quality?

Nurse-to-patient ratio Signup and view all the answers

What is assessed using Donabedian's model in the context of health care quality assessment?

All of the above Signup and view all the answers

Which level of assessment evaluates the quality of care for seniors using chronic disease mortality rates?

Macrolevel Signup and view all the answers

What is used as a benchmark in the assessment process of health care system performance?

"Gold standard" Signup and view all the answers

Which aspect of health care system performance is evaluated using hospitalization costs at the macrolevel?

Efficiency Signup and view all the answers

'Insurance coverage comparison' is used as a measure for evaluating which aspect of health care system performance at the macrolevel?

Equity Signup and view all the answers

Which of the following does NOT fall under Donabedian's model for assessing health care quality?

Resources availability Signup and view all the answers

At the microlevel, what can be used to evaluate equity in health care system performance?

Insurance coverage Signup and view all the answers

What type of resources fall under Donabedian's model for assessing health care quality?

Material resources, human resources, and organizational resources Signup and view all the answers

Which level of assessment evaluates the efficiency of health care using medical care costs?

Microlevel Signup and view all the answers

What is the focus of the health system historically?

Cost Signup and view all the answers

How can health system efficiency be assessed?

By focusing on spending and outcomes Signup and view all the answers

What are clinical outcomes?

Specific consequences of healthcare interventions for individual patients Signup and view all the answers

When do clinical outcomes assessments begin?

After the provider-patient interaction Signup and view all the answers

Which of the following is an example of a clinical outcome?

5-year survival rates for pancreatic cancer treatment Signup and view all the answers

Why is patient perspective increasingly important in determining clinical outcomes success or failure?

To understand the impact of healthcare interventions Signup and view all the answers

What do clinical outcomes studies provide the foundation for?

Evidence-based medicine Signup and view all the answers

What do systematic reviews aggregate to provide more reliable findings?

Clinical outcomes studies Signup and view all the answers

What is the focus of the text?

Structures and processes of health care Signup and view all the answers

What are used to assess the quality of health care systems?

All of the above Signup and view all the answers

Which measure evaluates the number of deaths among infants under 1 year old?

Infant mortality rate Signup and view all the answers

What does HALE (Healthy Life Expectancy) take into account?

Years lived in less than full health Signup and view all the answers

Which type of death rate can be measured at the population level?

Crude death rate Signup and view all the answers

What is NOT a measure used to assess population health outcomes?

$f(x) = -4(x + 3)^2 + 2$ Signup and view all the answers

What is an example of a structure-oriented question in Donabedian's model for assessing health care quality?

How many hospital beds are available per 1000 population? Signup and view all the answers

What is the first step in developing a clinical practice guideline according to Shekelle, Woolf, Eccles, and Grimshaw (1999)?

Identifying and refining the subject area Signup and view all the answers

Why were the reviewers unable to recommend practice guidelines for the treatment of dementia with atypical antipsychotic drugs?

Insufficient scientific evidence Signup and view all the answers

What is a key point illustrated by the systematic review of atypical antipsychotic drugs for people with dementia?

Health care interventions are 'works in progress' Signup and view all the answers

What do clinical practice guidelines rely on when scientific evidence is absent or inconclusive?

Consensus of experienced clinicians and other experts Signup and view all the answers

What is becoming increasingly used by insurers and other payers to evaluate the quality of health care provided to patients?

Clinical practice guidelines Signup and view all the answers

What lays the foundation for assessing health care quality?

Clinical outcomes research, systematic reviews, and clinical practice guidelines Signup and view all the answers

What is a key requirement for an outcome measure used to hold providers accountable for care according to Baker and Chassin (2017)?

$ ext{Risk-adjustment methodology}$ including and accurately measuring risk factors associated with the outcome Signup and view all the answers

'Using outcome measures for accountability requires extreme care,' according to Baker and Chassin (2017), because:

$ ext{Outcome measures must be approached as rigorously as process measures}$. Signup and view all the answers

'The goal of medicine is to improve health outcomes for patients,' as stated by Baker and Chassin (2017), emphasizes the importance of:

$ ext{Improvement in health outcomes for patients}$. Signup and view all the answers

What is critical as value-based payment of providers gains momentum, according to the text?

Valid indicators of health care quality. Signup and view all the answers

What are proposed as criteria for all outcome measures used to hold providers accountable for care by Baker and Chassin (2017)?

Strong evidence that good medical care leads to improvement in the outcome within the time period for the measure. Signup and view all the answers

What is needed to ensure that the assessment process is adequate and fair, according to the text?

Reliable and valid assessment tools Signup and view all the answers

Study Notes

Health care system performance assessment influences the roles, practices, and training of healthcare professionals and organizations.
The book uses Aday et al.'s framework, which identifies three evaluation criteria: quality, equity, and efficiency.
Performance assessment can be conducted at the microlevel (organizations and treatments) or macrolevel (regions, states, nations).
At the microlevel, we can evaluate the quality of care for cataract patients using postsurgical complications, efficiency using medical care costs, and equity using insurance coverage.
At the macrolevel, we can evaluate the quality of care for seniors using chronic disease mortality rates, equity using insurance coverage comparison, and efficiency using hospitalization costs.
The assessment process requires a comparison to a "gold standard" or a "benchmark" - an entity's own past performance or another entity's performance.
Health care quality is assessed using Donabedian's model: structure, process, and outcomes.
Structure includes material resources, human resources, and organizational characteristics.
Process includes activities carried out by professional personnel and patients/families.
Examples of structure-oriented questions: nurse-to-patient ratio, hospital age, insurance coverage, and physician payment structure.
Examples of process-oriented questions: infection control policy adherence, medication error rate, and patient education effectiveness.
The text discusses various aspects of health care, focusing on structures, processes, and outcomes.
Structures and processes of health care impact outcomes, which are desirable changes in individual and population health.
The text covers several health care outcomes: population health and clinical outcomes.
Population health outcomes include life expectancy, mortality rates, and years of potential life lost. These measures are used to assess the quality of health care systems.
The text explains how to calculate life expectancy, premature death, and years of potential life lost.
Mortality rates can be measured at the population level, with different types of death rates (crude, cause-specific, age-specific, and age-adjusted).
The infant mortality rate is another population health outcome, measuring the number of deaths among infants under 1 year old.
The text also introduces the concept of healthy life expectancy (HALE), which takes into account years lived in less than full health.
The text emphasizes the importance of assessing health care outcomes to ensure quality, equitable, and efficient health care.

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Description

Learn about health-adjusted life expectancy measures like HALE, QALYs, DALYs, and YHL, which provide estimates of the years of life that can be expected in a specified state of health. Understand how these measures combine length and quality of life, mortality, disability, and perceived health status.