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Hip joint - Fractures - Research. --- Femoral Fractures --- Delivery of Health Care --- Health Planning --- Hip Injuries --- Fractures, Bone --- Health Care Economics and Organizations --- Health Care Quality, Access, and Evaluation --- Wounds and Injuries --- Leg Injuries --- Health Care --- Diseases --- Hip Fractures --- Health Priorities --- Surgery & Anesthesiology --- Health & Biological Sciences --- Surgery - General and By Type --- Hip joint --- Fractures --- Research. --- Wounds and injuries. --- Coxa --- Joints

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Under the prospective payment system (PPS) introduced in 1983, hospitals are to be paid for each Medicare admission on the basis of a price per case set in advance, thus giving hospitals and other providers incentives for delivering care that are radically different from those of cost-reimbursement financing. This report identifies major issues relating to quality of care, sketches conceptual and practical aspects of carrying out appropriate studies of these issues, and outlines a quality-of-care research agenda. It emphasizes changes in hospital care that are most likely to occur secondary to PPS, those likely to have the most direct impact on patients' outcomes, and changes that can be defined, detected, and measured with relative ease. Certain themes for future research efforts are stressed: (1) the overall research agenda must be strong enough to detect clinically meaningful impacts on patient outcomes and to be able to assign those impacts to PPS; (2) outcomes other than death must be examined; (3) interpreting the impacts of PPS requires understanding the clinical circumstances of Medicare patients; (4) developing better outcome measures is essential; (5) targeting impact studies on high-priority topics will be unavoidable; and (6) a full picture of the effects of PPS requires a long-term perspective, extending beyond FY 1987.

Hospitals --- Older people --- Medical care --- Medicare. --- Health Services Research. --- Quality of Health Care --- Reimbursement, Prospective. --- Prospective payment --- Hospital care --- Quality control. --- economics. --- Health Insurance for Aged and Disabled, Title 18. --- United States.

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Clinical Medicine --- Delivery of Health Care --- Quality of Health Care --- standards --- standards --- standards --- United States.

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Medicare. --- Quality Assurance, Health Care. --- Health Care Quality Assessment --- Health Care Quality Assurance --- Healthcare Quality Assessment --- Healthcare Quality Assurance --- Quality Assessment, Healthcare --- Quality Assurance, Healthcare --- Quality Assessment, Health Care --- Assessment, Healthcare Quality --- Assessments, Healthcare Quality --- Assurance, Healthcare Quality --- Assurances, Healthcare Quality --- Healthcare Quality Assessments --- Healthcare Quality Assurances --- Quality Assessments, Healthcare --- Quality Assurances, Healthcare --- Health Insurance for Aged, Disabled, Title 18 --- Health Insurance for Aged, Title 18 --- Health Insurance for Aged and Disabled, Title 18 --- Insurance, Health, for Aged and Disabled --- United States. --- Medical care -- Quality control. --- Electronic books. -- local. --- Medical care --- Medicare --- Quality Assurance, Health Care --- United States --- North America --- Legislation as Topic --- Quality of Health Care --- Medical Assistance --- Insurance, Health --- Health Care Quality, Access, and Evaluation --- Insurance --- Public Assistance --- Health Care --- Health Services Administration --- Americas --- Social Control, Formal --- Financing, Organized --- Health Care Economics and Organizations --- Geographic Locations --- Financing, Government --- Economics --- Geographicals --- Quality control --- Quality control. --- Health insurance --- Older people --- Medicaid --- Medigap

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This report describes and reflects upon current quality assurance efforts in the health care field. It defines the concepts of quality of care and quality assurance, and recounts the history of the quality assurance movement. It then describes three initiatives in quality assurance sponsored by the federal government: Experimental Medical Care Review Organizations, Professional Standards Review Organizations, and Utilization and Quality Control Peer Review Organizations. The authors conclude that quality assurance is unlikely to grow in prominence or funding, but that the legacy of the federal programs is very positive. Methods for providing quality assurance as well as for evaluating quality assurance organizations showed progress in an environment almost wholly concentrated on controlling the costs of medical care.

Medical care --- Professional standards review organizations (Medicine) --- Quality Assurance, Health Care --- Peer Review. --- Professional Standards Review Organizations. --- Quality control.