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The goal of the Federation of State Medical Boards and its individual state members is to protect the public, reflecting the fundamental obligation of the physician expressed in the Latin: Primum non nocere—"first, do no harm." The Boards' duties in qual ity assurance are implemented through...
In order to determine whether the institution of the Medicare prospective payment system has led to poorer outcome and quality of care for patients hos pitalized with pneumonia at the Hershey Medical Center, a critical review of elderly pneumonia pa tients was performed for two time periods. The...
This paper defines quality assurance (QA) and dis cusses state-of-the art QA programs in managed care organizations today. Utilization management (UM) is distinguished from QA, although they are interre lated. While UM is process-oriented and focuses on efficiency and cost-effectiveness, QA is...
The cost of health care continues to be a matter of great concern to purchasers of service. In an effort to control their expenditures, many employers, insur ers, health maintenance organizations, and preferred provider organizations are assessing the effectiveness of their current...
A summary of the present status of peer review is presented with its implications dependent upon the awaited decision of the Supreme Court of the United States. The history of the Astoria Clinic and Dr. Patrick is detailed. Salient features of antitrust law are pointed out. Suggestions for a...
The authors have worked in the mental health uti lization review and quality assurance field for several years now. One author (S.L.-A.) has been involved in the start up of several case management and utiliza tion review programs. Their approach has been to assess existing techniques for case...
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