Quality of medical care

In a recent seminar, a medical expert noted that the United States has given away economic and technical dominance in industry after industry to other countries. Healthcare research is one of the few areas in which the U.S. enjoys unparalleled leadership which has enormous impact on the quality of medical care. If the healthcare industry and the academic medical enterprise falters—and this is in danger right now—I think it will be an absolute disaster for this country [40]. Many in pharmacy, medicine, and other healthcare fields would concur with the above statement. The problem is that many others in the public sector do not fully appreciate what is at stake. Pharmacists have an opportunity to help tell the story, as difficult as it sometimes is to convey. 

Improving quality of medication care in the elderly requires systematic processes for the team responsible for the patient care and also for individualisation of each patients care... 

In this book we have provided background for problems and examples of solutions to improve quality of medication care in the elderly. In this chapter we provide visions and objectives for further improvement in care of the elderly. We also summarise some very important practical aspects in the care of the elderly and give references to other chapters in this book. 

The death rate for heart disease has actually been declining over the past few decades, while the number of patients with CAD is increasing. This may reflect increasing quality of medical care, but it should be noted that in the elderly, heart disease becomes an ever more important cause of death, much more so than cancer. There are also concerns that while a lot of attention has been directed at smoking and cholesterol as risk factors, hypertension and diabetes are emerging as the next generation of major risk factors and are further accentuated in our increasingly obese and sedentary society. 

McKee M, Black N. Does the current use of junior doctors in the United Kingdom affect the quality of medical care Soc Sci Med 1992 34(5) 549-558. 

The U.S. Office of Technology Assessment has defined the quality of medical care as evaluation of the performance of medical providers according to the degree to which the process of care increases the probability of outcomes desired by patients and reduces the probability of undesired outcomes, given the state of medical knowledge (Congress of the United States, Office of Technology Assessment, 1988). 

Congress of the United States, Office of Technology Assessment. 1988. The Quality of Medical Care Information for Consumers, p. x. Washington, DC U.S. Government Printing Office. 

Donabedian A. Evaluating the quality of medical care. Milbank Mem. Fund Q. 1966 44 166-203. 

Jencks SF, Cuerdon T, Burwen DR, Fleming B, Houck PM, Kussmaul AE et al. Quality of medical care delivered to Medicare beneficiaries a profile at state and national levels. JAMA 2000 284 1670-1676. 

The types of outcomes that result from medical care interventions can be described in a number of ways. One classic fist, called the five D s, although quite negatively worded, captures a wide range of outcomes used in assessing the quality of medical care. The five D s are death, disease, disability, discomfort, and dissatisfaction. 

The institute s work centers principally on committee reports or studies on subjects ranging from quality of medical care to medical errors. The majority of the studies and other activities receive funds from the federal government. Other studies can be initiated by private industry, foundations, state or local governments, and the institute. 

Riveros C, Dechartres A, Perrodeau E et al (2013) Timing and completeness of trial results posted at QinicalTtials.gov and published in journals. PLoS Med 10 el001566 Rose L, Haslam L, Dale C, Knechtel L, McGillion M (2013) Behavioral pain assessment tool for critically ill adults unable to self-report pain. Am J Crit Care 22 246-255 Roter D, Hall JA (2013) Doctor-patient communication why and how communication contributes to the quality of medical care. In Gellman MD, Turner JR (eds) Encyclopedia of behavioral medicine. Springer, New York, pp 622-627... 

With the marked increase in GDP, the health human resources shortage has worsened in Taiwan over the last decade (11), as has the category of paramedical personnel in the LTCF. Although recently, immigrant HCWs have temporarily filled the need, to ensure patient safety and quality of medical care, they require regulations and standardized training programs. 

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