Effectiveness in Health Care

Rx-to-OTC Switch Movement

“…Payers (Medicare and Medicaid included) develop practice guidelines and demand that physicians abide by them. Increasingly, physicians--especially younger doctors (up to half of them)-are salaried employees of provider groups such as HMOs (Leary 1992c;Roper et al 1988). Even those remaining in private solo practice face fixed fee schedules and shrinking income (McKinley and Stoechle 1988,195).…”

Health Care Rationing and Cost Containment Are Not Synonymous

“…A related approach, called "outcomes management," is being pushed by Ellwood (1988), who envisions a data-gathering system that would constitute a kind of continuous clinical trial. HCFA is sponsoring an Effectiveness Initiative, with components of patient outcome assessment research, sharing Medicare's clinical and claims data with outside researchers, and disseminating assessment research results to t h e medical profession and the public (Cronin, 1988;Roper e t al., 1988). And a Patient Outcome Assessment Research Program with $6 million funding in FY 1989 is an ongoing effort of t h e National Health Center for Health Services Research and Health Care Technology Assessment (Fitzmaurice et al, 1989).…”

II. State Report: Measuring Quality In California

“…24 There is much to be learned, tested, revised, and resolved before any broadly applied methodology will provide uniform, reliable, and timely information for decision making. No product now exists whose mandated purchase will meet the needs of all parties intensely interested in quality assessment.…”