The gap between the care patients should get and what they actually receive likely contributes to thousands of preventable deaths each year, and health care systems worldwide continue to face the challenge of delivering quality care at an affordable cost. RAND has conducted research designed to measure and improve health care quality and to provide reliable decision support data to patients, providers, and purchasers.
Regions of the United States where doctors and hospitals are consolidated into large networks are more likely to have accountable care organizations, medical practice structures intended to improve medical care and cut costs.
An essential aspect of patient-centered outcomes research (PCOR) and comparative effectiveness research (CER) is the integration of patient perspectives and experiences with clinical data to evaluate interventions.
Provider responses to the Medicare inpatient rehabilitation facility prospective payment system were found to simultaneously reduce marginal reimbursement and increase average reimbursement.
The quality of clinical care and the quality of interpersonal care should be considered separately to give an overall assessment of medical care.
Early death after emergency department (ED) discharge may signal opportunities to improve care.
Transparency varies across websites that provide information on the performance of medical providers. This is especially true of how providers can review or correct results, how case mix adjustments are made, and how the reliability of measures is assessed.
New interventional cardiac catheterization services offered by U.S. hospitals generally duplicate existing programs and do not help patients gain access to timely emergency cardiac care. Instead, the focus has been on competing with other hospitals.
Alignment with best P4P practices varies across Medicare programs; the program for Medicare Advantage aligns most strongly. It is unclear which P4P design elements are critical for quality improvement. Unintended consequences of design features are poorly understood.
Incorporating community programs such as churches, social service providers, and beauty salons into efforts to improve depression care in low-income neighborhoods can help improve quality of life and lower the risk of a life crisis.
The Quality-Cost Framework describes the mechanisms by which health-related quality of care affects health care and health status–related costs.
This paper discusses challenges to evaluation of chronic disease management as reported by experts in six European countries.
The medical home has gained national attention as a model to reorganize primary care to improve health outcomes. Pennsylvania has undertaken one of the largest state-based, multipayer medical home pilot projects.
Ongoing efforts to profile physicians on their relative cost of care have been criticized because they do not account for differences in patients' socioeconomic status (SES).
Questionnaires suggest similar levels of satisfaction between patrons of mail-pharmacy services and those using traditional pharmacy services.
To prevent and respond to falls, many hospitals employ numerous techniques, including patient education, bed-exit alarms, post-fall evaluations, and more. However, better reporting of outcomes, implementation, adherence, and interventions is necessary to establish evidence on how hospitals can best prevent falls.
Improvements in provider-patient communication can enhance efficiency and lead to higher-quality care. However, the success of communication interventions depends largely on the motivation and skill of the participating providers.
The HCAHPS Survey obtains hospital patients' experiences using four modes: Mail Only, Phone Only, Mixed (mail/phone follow-up), and Touch-Tone (push-button) Interactive Voice Response with option to transfer to live interviewer (TT-IVR/Phone).
A team from RAND and the University HealthSystem Consortium (UHC) developed a toolkit to help hospitals enhance their quality improvement efforts using quality indicators from the Agency for Healthcare Research and Quality.
Patient-facing kiosks are feasible in routine care and can provide data that can be used to substantially improve the quality of care.
Substance use disorders are a serious issue, but treatment is often sporadic, despite ongoing need. Low rates of follow-up care among adults who received detoxification without subsequent residential treatment and among those with serious mental illness suggest that targeting these individuals could help.