TY - JOUR
T1 - Evaluating health plan quality 1
T2 - A conceptual model
AU - Wholey, Douglas R.
AU - Christianson, Jon B.
AU - Finch, Michael
AU - Knutson, David
AU - Rockwood, Todd
AU - Warrick, Louise
PY - 2003/6/1
Y1 - 2003/6/1
N2 - Objective: To develop a theoretical foundation for measuring health plan quality from a physician's perspective. Study design: Literature review and theory development. Methods: We defined health plan quality as the degree to which health plan management practices increase the likelihood of high-quality care for individuals and populations and addressed the ways in which health plan quality is similar to, and different from, other commonly used quality measures. Based on an assessment of the literature, we proposed a conceptual model that organizes health plan care management practices into a coherent structure for measuring health plan quality. Results: A conceptual model of health plan operation that organizes managerial practices into a structure for measuring health plan quality from a physician's perspective was developed. Conclusion: Health plan quality is distinct from quality of care, and physicians can provide unique, timely, and reliable information about aspects of health plan quality.
AB - Objective: To develop a theoretical foundation for measuring health plan quality from a physician's perspective. Study design: Literature review and theory development. Methods: We defined health plan quality as the degree to which health plan management practices increase the likelihood of high-quality care for individuals and populations and addressed the ways in which health plan quality is similar to, and different from, other commonly used quality measures. Based on an assessment of the literature, we proposed a conceptual model that organizes health plan care management practices into a coherent structure for measuring health plan quality. Results: A conceptual model of health plan operation that organizes managerial practices into a structure for measuring health plan quality from a physician's perspective was developed. Conclusion: Health plan quality is distinct from quality of care, and physicians can provide unique, timely, and reliable information about aspects of health plan quality.
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M3 - Review article
C2 - 12822715
AN - SCOPUS:0037622981
SN - 1088-0224
VL - 9
SP - SP53-SP64
JO - American Journal of Managed Care
JF - American Journal of Managed Care
IS - SPEC. ISS. 2
ER -