Despite years of discussion and sincere concern, we are still in the infant stage of measurement and evaluation of quality primary health care. Quality and related issues of accountability and cost are central to development of health services, yet there is a lack of consensus on the meaning of quality and how quality can be measured in practice. Discussions of quality have included the concept of outcomes, assuming that "good" outcomes prove "good" quality. Commonly used outcomes often fail it reflect high quality health care. A patient can be highly satisfied with incorrect or inappropriate clinical care; a patient can adhere to a regime which is not effective; or a patient can receive clinical care which is "state-of-the-art" and be dissatisfied with the care they received. This paper will propose an approach to defining quality of primary health care as the relative balance of three categories of outcomes broadly categorized as 1) behavioral, 2) experiential, and 3) clinical. Quality of care is different for different patient populations. The weight given outcomes differ depending on clients' unique conditions, life situations and needs. For example, behavioral and clinical outcomes might be heavily weighted for adolescents with insulin dependent diabetes, while experiential outcomes might need the greatest emphasis for older adult diabetics. This paper will define and describe examples of clinically oriented approaches that demonstrate the practical application of a model that evaluates quality of care as a balance of outcomes for specific patient populations.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Describe the current difficulties with defining quality of care 2. Analyze the impact of definitional concerns on the current state of outcome measurement 3. Identify a model for defining quality as the relative balance of three categories of outcomes 4. List the three broad categories of outcomes in the model 5. Apply the categories of outcomes to population specific factors in order to see how quality may differ for different patient population groups
Keywords: Quality, Outcome Measures
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.