Backgroud : lt is often difficult to understand where responsability lies for monitoring and improving quality in managed care.
From 1996 through 1998 a group of individuals convened by the Institute of Medecine's (Washington, DC) National Roundtable on Health Care Quality developed a model of accountability for the quality of care provided by managed care organizations (MCOs).
Each of three overarching forms of accountability (professional, market, and regulatory) has a set of tools for imposing accountability and-because accountability relationships are not self-enforcing-sanctions for failures of accountability.
Professional accountability : Fiduciary relationships in medicine are an essentiel part of any quality accountability mechanism, and it will be important to maintain the strenght of the professional model in the changing health care system.
Yet it is not easy to preserve the strenght of the professional model in an MCO environment in which professionals are not dominant, and there is likely to be increasing pressure to weaken their autonomy.
Market accountability : The primary assumption of market accountability is that consumers will select options based on perceived value to them and will make new choices based on their information and experience.
Market accountability requires choice among competing providers and information to inform choice.
In health care, however, individuals rarely have the information they need and often do not have choice. (...)
Mots-clés Pascal : Soin, Etats Unis, Amérique du nord, Amérique, Monde, Responsabilité professionnelle, Responsabilité, Qualité, Aspect politique, Géographie, Réseau, Soin intégré
Mots-clés Pascal anglais : Care, United States, North America, America, World, Occupational responsibility, Responsibility, Quality, Political aspect, Geography, Network, Managed care
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 19/02/1999.