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Volumn 30, Issue 6, 2011, Pages 1185-1191

How intermountain trimmed health care costs through robust quality improvement efforts

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CESAREAN SECTION; CLINICAL PROTOCOL; COST CONTROL; ELECTIVE SURGERY; EVIDENCE BASED PRACTICE; FINANCIAL MANAGEMENT; HEALTH CARE COST; HEALTH CARE DELIVERY; HEALTH CARE MANAGEMENT; HEALTH CARE ORGANIZATION; HEALTH CARE PERSONNEL; HEALTH CARE PLANNING; HEALTH CARE POLICY; HEALTH CARE PRACTICE; HEALTH CARE QUALITY; HEALTH CARE UTILIZATION; HEALTH HAZARD; HOSPITAL ADMISSION; HUMAN; LABOR INDUCTION; LONG TERM CARE; MEDICAL FEE; MEDICAL RESEARCH; NEWBORN; NEWBORN INTENSIVE CARE; PATIENT CARE; PHYSICIAN; PRACTICE GUIDELINE; UNITED STATES;

EID: 79957958439     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.0358     Document Type: Article
Times cited : (227)

References (22)
  • 2
    • 0346280438 scopus 로고
    • What is a TURP? Controlling variation in the performance of clinical processes
    • Blumenthal D, Scheck AC, editors. San Francisco (CA): Jossey-Bass;
    • James BC. What is a TURP? Controlling variation in the performance of clinical processes. In: Blumenthal D, Scheck AC, editors. Improving clinical practice: total quality management and the physician. San Francisco (CA): Jossey-Bass; 1995. p. 167-202.
    • (1995) Improving clinical practice: total quality management and the physician , pp. 167-202
    • James, B.C.1
  • 3
    • 0039862135 scopus 로고    scopus 로고
    • The core statistical problem was low numbers of complications and treatment failures, which limited our ability to construct unbiased cohorts of comparable patients. Although our analyses showed statistical significance over all, the physician rankings had extremely wide confidence intervals. This challenge has been well documented in many clinical settings. League tables and their limitations
    • See, for example, Goldstein H, Spiegelhalter DJ
    • The core statistical problem was low numbers of complications and treatment failures, which limited our ability to construct unbiased cohorts of comparable patients. Although our analyses showed statistical significance over all, the physician rankings had extremely wide confidence intervals. This challenge has been well documented in many clinical settings. See, for example, Goldstein H, Spiegelhalter DJ. League tables and their limitations: statistical issues in comparisons of institutional performance. J Roy Statistical Society. 1996;159(3): 385-443.
    • (1996) J Roy Statistical Society , vol.159 , Issue.3 , pp. 385-443
  • 8
    • 47549098034 scopus 로고    scopus 로고
    • Health system use of clinical programs to build quality infrastructure
    • Nelson EC, Batalden PB, Lazar JS, editors. Oakbrook Terrace (IL): Joint Commission Resources
    • James BC, Lazar JS. Health system use of clinical programs to build quality infrastructure. In: Nelson EC, Batalden PB, Lazar JS, editors. Practice-based learning and improvement: a clinical improvement action guide. Oakbrook Terrace (IL): Joint Commission Resources; 2007. p. 95-108.
    • (2007) Practice-based learning and improvement: a clinical improvement action guide , pp. 95-108
    • James, B.C.1    Lazar, J.S.2
  • 9
    • 0028456082 scopus 로고
    • The Malcolm Baldrige National Quality Award concept: could it help stimulate or accelerate health care quality improvement?
    • Hertz HS, Reimann CW, Bostwick MC. The Malcolm Baldrige National Quality Award concept: could it help stimulate or accelerate health care quality improvement? Qual Manag Health Care. 1994;2(4):63-72.
    • (1994) Qual Manag Health Care , vol.2 , Issue.4 , pp. 63-72
    • Hertz, H.S.1    Reimann, C.W.2    Bostwick, M.C.3
  • 11
    • 0037264627 scopus 로고    scopus 로고
    • Connections between quality measurement and improvement
    • Berwick DM, James BC, Coye MJ. Connections between quality measurement and improvement. Med Care. 2003;41(1 Suppl):I30-8.
    • (2003) Med Care , vol.41 , Issue.1 SUPPL.
    • Berwick, D.M.1    James, B.C.2    Coye, M.J.3
  • 13
    • 79959519082 scopus 로고    scopus 로고
    • An intermediate outcome often represents a process measure
    • An intermediate outcome often represents a process measure.
    • (2000)
  • 14
    • 79951761691 scopus 로고    scopus 로고
    • Sudden acceleration of diabetes quality measures
    • Pogach L, Aron DC. Sudden acceleration of diabetes quality measures. JAMA. 2011;305(7):709-10.
    • (2011) JAMA , vol.305 , Issue.7 , pp. 709-710
    • Pogach, L.1    Aron, D.C.2
  • 15
    • 0033533883 scopus 로고    scopus 로고
    • The unintended consequences of measuring quality on the quality of medical care
    • Casalino LP. The unintended consequences of measuring quality on the quality of medical care. N Engl J Med. 1999;341(15):1147-50.
    • (1999) N Engl J Med , vol.341 , Issue.15 , pp. 1147-1150
    • Casalino, L.P.1
  • 16
    • 79959532882 scopus 로고
    • Creating learning organizations
    • 93
    • Ackoff R. Creating learning organizations. Syst Thinker. 1992-93; 3(10):6.
    • (1992) Syst Thinker , vol.3 , Issue.10 , pp. 6
    • Ackoff, R.1
  • 17
    • 65649134334 scopus 로고    scopus 로고
    • Decreasing elective deliveries before 39 weeks of gestation in an integrated health care system
    • Oshiro BT, Henry E, Wilson J, Branch DW, Varner MW. Decreasing elective deliveries before 39 weeks of gestation in an integrated health care system. Obstet Gynecol. 2009; 13(4):804-11.
    • (2009) Obstet Gynecol , vol.113 , Issue.4 , pp. 804-811
    • Oshiro, B.T.1    Henry, E.2    Wilson, J.3    Branch, D.W.4    Varner, M.W.5
  • 18
    • 79957999210 scopus 로고    scopus 로고
    • Cost cutting in health systems without compromising quality care
    • Clark DD, Savitz LA, Pingree SB. Cost cutting in health systems without compromising quality care. Front Health Serv Manage. 2010; 27(2):19-30.
    • (2010) Front Health Serv Manage , vol.27 , Issue.2 , pp. 19-30
    • Clark, D.D.1    Savitz, L.A.2    Pingree, S.B.3
  • 19
    • 79959519502 scopus 로고    scopus 로고
    • Centers for Medicare and Medicaid Services. Baltimore (MD): CMS; [cited Apr 15]. Available from
    • Centers for Medicare and Medicaid Services. NHE summary including share of GDP, CY 1960-2009 [Internet]. Baltimore (MD): CMS; [cited 2011 Apr 15]. Available from: http://www.cms.gov/NationalHealthExpendData/02_NationalHealthAccountsHistorical.asp.
    • (2011) NHE summary including share of GDP, CY 1960-2009 [Internet]
  • 20
    • 0025397544 scopus 로고
    • The Rand Health Insurance Experiment and HMOs
    • Wagner EH, Bledsoe T. The Rand Health Insurance Experiment and HMOs. Med Care. 1990;28(3): 191-200.
    • (1990) Med Care , vol.28 , Issue.3 , pp. 191-200
    • Wagner, E.H.1    Bledsoe, T.2
  • 21
    • 79959496876 scopus 로고    scopus 로고
    • Letter from Douglas W. Elmendorf, director of the Congressional Budget Office, to US House of Representatives Speaker Honorable Nancy Pelosi regarding HR 4872 the Reconciliation Act of 2010 [Internet] Washington (DC): CBO;2010 Mar 20 [cited Apr 15]. Available from
    • Elmendorf DW. Letter from Douglas W. Elmendorf, director of the Congressional Budget Office, to US House of Representatives Speaker Honorable Nancy Pelosi regarding HR 4872, the Reconciliation Act of 2010 [Internet]. Washington (DC): CBO; 2010 Mar 20 [cited 2011 Apr 15]. Available from: http://cbo.gov/ftpdocs/113xx/doc11379/AmendReconProp.pdf.
    • (2011)
    • Elmendorf, D.W.1
  • 22
    • 79959529060 scopus 로고    scopus 로고
    • This short version of Intermountain Healthcare's mission statement is used frequently in Intermountain's clinical and administrative leadership meetings
    • This short version of Intermountain Healthcare's mission statement is used frequently in Intermountain's clinical and administrative leadership meetings.
    • (2000)


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.