Question

HSM 541 Biggest challenge in health care delivery system is as followed: 1. Quality health care challenge 2. Controlling and monitoring private parties involved. The existing delivery system neglected care. Clinical preventative services are having good vision to take care of the needed people or class of societies. The qualitative aspects need to be improved and there should be some standardization. Donabedian’s model is actually a conceptual model of health care; quality of care can be viewed or evaluated from three categories: “structures”, “process,” and “outcomes.” Structure: Facility, Equipment. Process involves treatment, care and extra beneficial activities. Outcomes means results of care and satisfaction. -How will quality healthcare be measured and controlled?

Answer 1

MEASUREMENT:

According to the Donabedian's model the quality health care can be measured and controlled by evaluating the following 3 aspects :

Structure: Facility including hospital buildings, staff, financing, and Equipment. It is meaured by — Direct observation and Supervisory checklist.

Process involves treatment, care and extra beneficial activities. It denotes the transactions between patients and providers. The measurement of process can be obtained from medical records, interviews with patients and practitioners to obtain feedback, or direct observations of healthcare visits,technical quality of services, counseling quality and quality of interpersonal relations. the main criteria of process measurement involve Participant observation, Exit interviews and Data quality assessment and Promotion of continuity of care.

Outcomes means results of care and satisfaction i.e. the effects of healthcare on the health status of patients which can be measured via surveys of Client satisfaction , Client perception of quality, Client knowledge, attitudes and also the Client behaviors

CONTROL:

If any of the aforementioned aspects is found to be in the need of improvement or control, it can be done by increasing and modifying the following

1. Effectiveness by Offering services that address the most important health problems of the most vulnerable groups, integrating the curative and preventive services and attaining high population coverage
2. Efficiency by Rationalizing essential drug supply and Routinely using the available information for decision-making. Costs can be monitored at each level. Some strategies which can be used are procuring the essential generic drugs, simplifying the Management information system, and monitoring the Recurrent costs in relation to coverage
3. Sustainability by Sharing costs and improving the Community control, imposing Locally affordable user fees, regularly assessing the Local operating costs, monitoring the Community health management committees and control funds
4. Equity by Serving the underserved, Allowing exemptions and Using cross-subsidies via Marking up costs of inexpensive treatments to crosssubsidize more expensive but essential treatments and thereby Exempting the truly indigent patients through case-by-case basis