Biomedical subjects

W B Credé

Publications and source records attributed to W B Credé.

4 recordsLinked to original sources

PubMed1990

Surveillance for quality assessment: III. The critical assessment of quality indicators.

Increased attention to healthcare quality issues by insurers, the public and providers has created the desire for quantitative indicators of high quality care. Attributes of quality indicators, including primary and secondary definitions, predictive accuracy and potential to define avoidable problems in care, have been discussed in an effort to allow the reader to critique suggested quality indicators as they appear through legislation and the literature. A continuous feedback process between reviewers and reviewees in the quality assessment process is mandatory to optimize the performance of quality indicators.

Cross Infection↗

PubMed1989

Utilization review and management: a brief analysis of a growth industry.

Current evidence concerning the prevalence of inappropriate care indicates that there is an opportunity for significant utilization and cost reductions. Although the efficacy of some methods of utilization control has been demonstrated, the clinical impact and safety of these techniques are unclear. Although financial incentives have been successful in nonhealth industries, there is no evidence that fiscal rewards will eliminate inappropriate use rather than necessary care. Both short- and long-term quality assurance monitors should be combined with any utilization control method promoting "appropriate" use of inpatient beds and hospital services.

Cost Control↗

PubMed1989

Analytic strategies in hospital epidemiology: cross-sectional studies.

Prevalence studies have long been a cornerstone of chronic disease epidemiology and infectious hospital epidemiology. However, application of cross-sectional techniques to non-infectious areas of hospital epidemiology has been limited to large scale period prevalence studies of mortality. The architecture of cross-sectional studies was reviewed in detail, highlighting the descriptive power of such studies and acknowledging problems in proving causation as opposed to association. An application of cross-sectional methodology in evaluating blood product use, which takes advantage of the descriptive strengths of the method and availability of information concerning indications for blood use, was outlined. The cross-sectional method should be as useful a tool in evaluating non-communicable disease quality of care as it has been in infectious disease-related hospital epidemiology.

Blood Transfusion↗

PubMed1988

Mortality rates as a quality indicator: a simple answer to a complex question.

Clinical, administrative, and information issues have been reviewed that may impact on the sensitivity of mortality rates as a quality indicator. It is clear that current technology cannot necessarily identify high-risk institutions through the use of abstracted discharge data. Furthermore, even if this screening capability is improved, verification of quality problems still requires detailed chart review. Quality of health care delivery will continue to be scrutinized by various groups, only some familiar with clinical risk adjustment and the actual process of care. In order to promote the accuracy and fairness of the review process, objective, outcome-based criteria for high-quality care must be developed for many clinical situations, and clinicians must continue to be involved in quality assessment.

Cause of Death↗