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健康维护组织评价与数据信息集(HEDIS)如何影响健康维护组织(HMO)中的质量改进策略?

How does HEDIS affect quality improvement strategies in an HMO?

作者信息

Hill J W, Spoeri R K

机构信息

NYLCare Health Plans, New York City, USA.

出版信息

Manag Care Interface. 1997 Nov;10(11):60-5.

Abstract

To meet the demands of the marketplace, health plans devote considerable resources to comply with Health Plan Employer Data and Information Set (HEDIS) reporting standards and to improve performance along those measures. Given HEDIS's growing prominence, one might question whether it plays a major role in the formulation of an HMO's quality improvement strategies. The experience at NYLCare Health Plans, Inc., suggests that quality improvement strategies should focus on strengthening the ability of HMOs to meet the more general agenda of quality measurement and improvement, and not just requirements specific to HEDIS.

摘要

为满足市场需求,健康计划投入大量资源以符合健康计划雇主数据与信息集(HEDIS)报告标准,并在这些指标上提升绩效。鉴于HEDIS日益显著,有人可能会质疑它在健康维护组织(HMO)质量改进策略的制定中是否发挥主要作用。纽约关怀健康计划公司的经验表明,质量改进策略应专注于增强健康维护组织满足质量衡量与改进这一更广泛议程的能力,而不仅仅是符合HEDIS的特定要求。

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