Evidence report/technology assessment
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Evid Rep Technol Assess (Full Rep) · Aug 2012
Review Meta AnalysisClosing the quality gap: revisiting the state of the science (vol. 3: quality improvement interventions to address health disparities).
This review evaluates the effectiveness of quality improvement (QI) strategies in reducing disparities in health and health care. ⋯ The literature on QI interventions generally and their ability to improve health and health care is large. Whether those interventions are effective at reducing disparities remains unclear. This report should not be construed to assess the general effectiveness of QI in the health care setting; rather, QI has not been shown specifically to reduce known disparities in health care or health outcomes. In a few instances, some increased effect is seen in disadvantaged populations; these studies should be replicated and the interventions studied further as having potential to address disparities.
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Evid Rep Technol Assess (Full Rep) · Aug 2012
ReviewClosing the quality gap: revisiting the state of the science (vol. 1: bundled payment: effects on health care spending and quality).
"Bundled payment" is a method in which payments to health care providers are related to the predetermined expected costs of a grouping, or "bundle," of related health care services. The intent of bundled payment systems is to decrease health care spending while improving or maintaining the quality of care. ⋯ There is weak but consistent evidence that bundled payment programs have been effective in cost containment without major effects on quality. Reductions in spending and utilization relative to usual payment were less than 10 percent in many cases. Bundled payment is a promising strategy for reducing health spending. However, effects may not be the same in future programs that differ from those included in this review.