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Quality Care in Surgery

Quality Care in Surgery SPECIAL ARTICLE Gerald W. Peskin, MD uring the past several years, one of the most perplexing issues for surgeons has been the assessment of quality of care. We, however, owe it to ourselves and our patients to master the substantive issues that underlie current discussions about this subject. D What is quality care? Many definitions have been proposed. Donabedian developed the classic triad for measuring quality in health care: structure, process, and outcome. Structural data are characteristics of physicians and hospitals (eg, specialty of physicians, ownership of hos- pitals). Process data result from an interaction between physician and patient (eg, tests ordered). “Outcome” refers to the subsequent health status of the patient (eg, improvement in gastrointes- tinal function). To be credible, structure and process must lead to differences in outcome, and out- come data, to be valid, must show that differences will result if processes of care, under the control of the provider, are modified. There are critics of each approach. When used appropriately, both process and outcome measures can provide important information about the quality of care. We, as surgeons, rely heavily on outcome data. In 1990, the Institute of Medicine defined quality as: “The degree to which http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Quality Care in Surgery

JAMA Surgery , Volume 137 (1) – Jan 1, 2002

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Publisher
American Medical Association
Copyright
Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/archsurg.137.1.13
Publisher site
See Article on Publisher Site

Abstract

SPECIAL ARTICLE Gerald W. Peskin, MD uring the past several years, one of the most perplexing issues for surgeons has been the assessment of quality of care. We, however, owe it to ourselves and our patients to master the substantive issues that underlie current discussions about this subject. D What is quality care? Many definitions have been proposed. Donabedian developed the classic triad for measuring quality in health care: structure, process, and outcome. Structural data are characteristics of physicians and hospitals (eg, specialty of physicians, ownership of hos- pitals). Process data result from an interaction between physician and patient (eg, tests ordered). “Outcome” refers to the subsequent health status of the patient (eg, improvement in gastrointes- tinal function). To be credible, structure and process must lead to differences in outcome, and out- come data, to be valid, must show that differences will result if processes of care, under the control of the provider, are modified. There are critics of each approach. When used appropriately, both process and outcome measures can provide important information about the quality of care. We, as surgeons, rely heavily on outcome data. In 1990, the Institute of Medicine defined quality as: “The degree to which

Journal

JAMA SurgeryAmerican Medical Association

Published: Jan 1, 2002

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