Appropriateness in health care delivery: Definitions, measurement and policy implications

CMAJ. Canadian Medical Association Journal

Volumn 154, Issue 3, 1996, Pages 321-328

  Lavis, John N ^a   Anderson, Geoffrey M ^b,c  

^a HARVARD UNIVERSITY   (United States)

^b INSTITUTE FOR CLINICAL EVALUATIVE SCIENCES   (Canada)

^c UNIVERSITY OF TORONTO   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

CANADA; HEALTH CARE DELIVERY; HEALTH CARE POLICY; HEALTH CARE SYSTEM; HOSPITAL PATIENT; OUTPATIENT; PRACTICE GUIDELINE; REVIEW;

EID: 0030063839     PISSN: 08203946     EISSN: 14882329     Source Type: Journal    
DOI: None     Document Type: Review

References (42)

1. Working Group on Utilization Management: When Less Is Better: Using Canada's Hospitals Efficiently, Conference of Federal/Provincial/Territorial Deputy Ministers of Health, Ottawa, 1994
2. Lavis JN, Anderson GM: Inappropraite Hospital Use in Canada: Definition, Measurement, Determinants and Policy Implications [University of Ottawa Graduate School working paper 93-08], Cost-Effectiveness of the Canadian Health Care System, Queen's-University of Ottawa Economic Projects, Ottawa, 1993
3. Yusuf S, Zucker D, Perduzzi P et al: Effect of coronary artery bypass graft surgery on survival. Lancet 1994; 344: 563-570
4. Brook RH, Chassin MR, Fink A et al: A method for the detailed assessment of the appropriateness of medical technologies. Int J Technol Assess Health Care 1986; 2: 53-63
5. Park RE, Fink A, Brook RH et al: Physician ratings of appropriate indications for six medical and surgical procedures. Am J Public Health 1986; 76: 766-772
6. Kleinman LC, Kosecoff J, Dubois RW et al: The medical appropriateness of tympanostomy tubes proposed for children younger than 16 years in the United States. JAMA 1994; 271: 1250-1255
7. Phelps CE: The methodologic foundations of studies of the appropriateness of medical care. N Engl J Med 1993; 329: 1241-1245
8. Gertman PM, Restuccia JD: The Appropriateness Evaluation Protocol: a technique for assessing unnecessary days of hospital care. Med Care 1981; 19: 855-871
9. Kreger BE, Restuccia JD: Assessing the need to hospitalize children: Paediatric Appropriateness Evaluation Protocol. Pediatrics 1989; 84: 242-247
10. Strumwasser I, Paranjpe NV, Ronis DI, et al: Reliability and validity of utilization review criteria: Appropriateness Evaluation Protocol, Standardized Medreview Instrument and Intensity-Severity-Discharge Criteria. Med Care 1990; 28: 95-111
11. Kemper KJ, Fink HD, McCarthy PL: The reliability and validity of the Paediatric Appropriateness Evaluation Protocol. Qual Rev Bull 1989; 15: 77-80
12. Dyck FJ, Murphy FA, Murphy JK et al: Effect of surveillance on the number of hysterectomies in the province of Saskatchewan. N Engl J Med 1977; 296: 1326-1328
13. Roos LL, Bond R, Naylor CD et al: Coronary angiography and bypass surgery in Manitoba and the United States: a first comparison. Can J Cardiol 1994; 10: 49-56
14. McGlynn EA, Naylor CD, Anderson GM et al: Comparison of the appropriateness of coronary angiography and coronary artery bypass graft surgery between Canada and New York State. JAMA 1994; 272: 934-940
15. Chassin MR, Kosecoff J, Park RE et al: Does inappropriate use explain geographic variations in the use of health care services? A study of three procedures. JAMA 1987; 258: 2533-2537
16. Chassin MR, Kosecoff J, Solomon DH et al: How coronary angiography is used: clinical determinants of appropriateness. JAMA 1987; 258: 2543-2547
17. Brook RH, Kosecoff JB, Park RE et al: Diagnosis and treatment of coronary disease: comparison of doctors' attitudes in the USA and the UK. Lancet 1988; 1: 750-753
18. Bernstein SJ, Hilborne LH, Leape LL et al: The appropriateness of use of coronary angiography in New York State. JAMA 1993; 269: 766-769
19. Winslow CM, Kosecoff JB, Chassin M et al: The appropriateness of performing coronary artery bypass surgery. JAMA 1988; 260: 505-509
20. Leape LL, Hilborne LH, Park RE et al: The appropriateness of use of coronary artery bypass surgery in New York State. JAMA 1993; 269: 753-760
21. Merrick NJ, Brook RH, Fink A et al: Use of carotid endarterectomy in five California Veterans Administration Medical Centers. JAMA 1986; 256: 2531-2535
22. Winslow CM, Solomon DH, Chassin MR et al: The appropriateness of carotid endarterectomy. N Engl J Med 1988; 318: 721-727
23. Leape LL, Park RE, Kahan JP et al: Group judgments of appropriateness: the effect of panel composition. Qual Assur Health Care 1992; 4: 151-159
24. Kahn KL, Kosecoff J, Chassin MR et al: The use and misuse of upper gastrointestinal endoscopy. Ann Intern Med 1988; 109: 664-670
25. Kahn KL, Kosecoff J, Chassin MR et al: Measuring the clinical appropriateness of the use of a procedure. Can we do it? Med Care 1988; 26: 415-422
26. Kahn KL, Park RE, Vennes J et al: Assigning appropriateness ratings for diagnostic upper gastrointestinal endoscopy using two different approaches. Med Care 1992; 30: 1016-1028
27. Leape LL, Park RE, Solomon DH et al: Does inappropriate use explain small-area variations in the use of health care services? JAMA 1990; 263: 669-672
28. Davidson G: Does inappropriate use explain small-area variations in the use of health care services? A critique. Health Serv Res 1993; 28: 389-400
29. Park RE: Does inappropriate use explain small-area variations in the use of health care services? A reply. Health Serv Res 1993; 28: 401-410
30. Cain KC, Diehr P: Does inappropriate use explain small-area variations in the use of health care services? A commentary. Health Serv Res 1993; 28: 411-418
31. Anderson GM, Sheps S, Cardiff K: Evaluation of VI-CARE a Utilization Management Program of the Greater Victoria Hospital Society [working paper 93:1D], Health Policy Research Unit, University of British Columbia, Vancouver, 1993
32. Barriers to Community Care. Summary Report, Hospital Services Utilization Review Commission, Saskatoon, 1994
33. Kasian GF, Zinkiew K, Senthilselvan A: Inappropriate hospital bed days at a Canadian paediatric tertiary care centre. Ann R Coll Physicians Surg Can 1992; 25: 275-278
34. Gloor JE, Kissoon N, Joubert GI: Appropriateness of hospitalization in a Canadian paediatric hospital. Pediatrics 1993; 91: 70-74
35. Smith HE, Sheps S, Matheson DS: Assessing the utilization of in-patient facilities in a Canadian pediatric hospital. Pediatrics 1993; 92: 587-593
36. Kemper KJ: Medically inappropriate hospital use in a pediatric population. N Engl J Med 1988; 318: 1033-1037
37. Siu AL, Sonnenberg FA, Manning WG et al: Inappropriate use of hospitals in a randomized trial of health insurance plans. N Engl J Med 1986; 315: 1259-1266
38. Siu AL, Leibowitz A, Brook RH et al: Use of the hospital in a randomized trial of prepaid care. JAMA 1988; 259: 1343-1346
39. Grumbach K, Bodenheimer T: Reins or fences: a physician's view of cost containment. Health Aff 1990; 9 (4): 120-126
40. Guidelines for Canadian Clinical Practice Guidelines, Canadian Medical Association, Ottawa, 1994
41. Anderson GM: Implementing practice guidelines. Can Med Assoc J 1993; 148: 753-755
42. Davis DD, Thomson MA, Oxman AD et al: Evidence for the effectiveness of CME. JAMA 1992; 268: 1111-1117