Articles: outcome-assessment-health-care.
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Careful review of the literature suggests that the conceptual problem in analyzing hospitals' quality of care is the difficulty of identifying problem domains of hospital care. An appropriate measurement model using multiple indicators of hospital quality problems is developed and evaluated. ⋯ The findings show that hospital characteristics exert limited effects on adverse outcomes. Efficiency and average length of stay are the only statistically significant factors that explain the variation in adverse outcomes.
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Malpractice claims data as a quality improvement tool. I. Epidemiology of error in four specialties.
--To identify potentially preventable sources of medical injury in obstetrics and gynecology, general surgery, anesthesiology, and radiology. ⋯ --Malpractice data can be used to identify problem-prone clinical processes and suggest interventions that may reduce negligence.
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--To evaluate the usefulness of malpractice claims data for identifying (1) physicians who are prone to negligent errors and (2) physician and hospital characteristics associated with particular kinds of errors. ⋯ --Use of physicians' malpractice claims histories to target individuals for education or sanctions is problematic because of the only modest predictive power of such claims histories.