Efforts to reform healthcare systems around the globe are proliferating rapidly. No country is immune from the two fundamental pressures that are driving change: cost and access. Every system is experimenting with measures designed to contain costs while simultaneously trying to determine how best to resolve the question of who should be eligible for what services under what conditions.In the midst of these experiments, serious concerns about quality are being raised. Are efforts to contain costs leading to practices which have a detrimental impact on quality? What, in fact, is "quality" in the world of healthcare? How should it be measured? And how can it be improved? These questions are on the cutting edge of debates about the management of healthcare in the future.This book examines these questions in detail by combining chapters outlining the basic issues with others describing state-of-the-art efforts to measure and manage quality more effectively. The result is an up-to-date compendium of issues and experiences presented by leading researchers and practitioners which should be of interest to healthcare managers and policy makers as well as to students and researchers in the field.
Introduction - the quality imperative - origins and challenges; Part 1 Perspectives: information systems and quality in health care; quality management in French hospitals - from implicit concern to radical change. Part 2 Practices: co-ordination and patient care outcomes; implementing continuous quality improvement; evaluation units in French hospitals - experiences and limitations; quality management at the University of Pennsylvania health system. Part 3 Potential: evaluating quality outcomes against best practice - a new frontier; rethinking quality - complexity and context in health care; the quality imperative - lessons and potential.