Health Care Advanced Quality of Medical Care

¶ … Health Care Advanced

Quality of Medical Care Defined and Other Dimensions of Quality Care and Their Importance

Quality is reported to be defined by the Institute of Medicine as:

"The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." (Feld, 2003, p.1)

The elements of quality care are stated to be those as follows:

(1) Recognition of patients at risk for diseases;

(2) Conduction of appropriate evaluation;

(3) Making the appropriate diagnosis;

(4) Starting the appropriate treatment;

(5) Scheduling the appropriate follow-up; and (6) Stimulating the appropriate compliance/adherence to treatment. (Feld, 2003, p.1)

The goals of quality care are decrease of the "complication rate, morbidity, mortality, and cost of care." (Feld, 2003, p.1) Changes since the days when the doctor knew best include a more informed population who are more highly educated and who possess more knowledge about their own healthcare regimen. The work of Steffen (2009) defines quality by stating that it is "not as consisting of the properties of an object but rather as the capacity of these properties to achieve goals. Accordingly, quality medical care is the capacity of the elements of that care to achieve legitimate medical and nonmedical goals." (p.1) Patient values are reported to be such that serve to shape the goals and since these values are many times non-assessed and unrecorded. It is reported that recommendations request, "A formal assessment of patient values [as those values] become part of the patient's record." (Steffan, 2009, p.1) Patient care is reported as having two components: (1) technical; and (2) interpersonal." (Donabedian, 1979) Donabedian states that the quality of technical management is dependent upon the "balance of its expected benefits and risks." (1979) The quality of the interpersonal process "consists in conformity to legitimate patient's expectations and to social and professional norms." (Donabedian, 1979, p.1)

II. Quality in Medical Care Defined as Greatest Benefit at Lowest Risk -- Examination of How the Priorities of the Healthcare System and Allocation of Resources Address this Goal

The work of Brock (2003) entitled "Separate Spheres and Indirect Benefits" reports that in health care resource priorities "the benefits and costs of different alternative resource uses are relevant considerations in the prioritization process." It is held by Consequentialists that the "maximization of benefits with available resources is the only relevant consideration" whereas the Non-consequentialists are reported to fail to reject the "…the relevance of consequences of benefits and costs, but insist that other considerations, and in particular the distribution of benefits and costs, are morally important as well." (Brock, 2003) It is certain that whatever one uses to morally justify their view of the proper standards for prioritization of various interventions in healthcare, there must be some way to measure both the benefits and costs of those interventions. Both theoretical and practical challenges present in taking such a measurement including the question of weighing the extension of life against improvement in the individual's health and their quality of life. Preventive health care has been prioritized in our health care system toward reduction of morbidity, mortality, and costs of health care services. Preventive care has served to reduce the rates of occurrence of life-threatening breast cancer and other conditions that previously were associated with a shorter than normal lifespan in the population who developed such diseases.

III. Contrasting the Definition of 'Implicit' and 'Explicit' Criteria in Health Care Quality Assessment and the Usefulness of Each Type of Assessment of Health Care Quality