Kaegi L
Jt Comm J Qual Improv. 1998 Nov;24(11):658-71. doi: 10.1016/s1070-3241(16)30414-x.
The Association for Health Services Research (AHSR) drew a record attendance of more than 2,100 to its 15th annual meeting, "Health Services Research: Implications for Policy, Delivery, and Practice," in Washington, DC, June 21-23, 1998. The conference offered 113 sessions, identifying policy roundtables and research report and panel sessions according to ten themes, with the "quality" theme on top and the effects of managed care a key concern. Selected presentations are reported.
The keynote address, "The Public and the Managed Care Backlash," examined managed care in the context of conditions shaping public issues in the United States. The tasks and prospects for the new President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry got close attention from expert and Commission-member panelists.
PROFESSIONAL ETHICS, ATTITUDES, AND PRACTICE UNDER MANAGED CARE: Competing viewpoints were brought to bear on questions about whether physicians are "double agents" under managed care and how managed care, considering its degree of market penetration, is affecting physicians' beliefs and practices. EVIDENCE-BASED MEDICINE: Experts reviewed the evidence about how practice guidelines are faring, what implementation methods work best, and how to overcome remaining barriers to use of evidence-based guidelines. Clinicians reported successful implementation experiences using collaborative benchmarking and practice-based assistance to improve prevention services delivery to children.
Panelists reported advances in quality measurement methods dealing with hard-to-measure entities, including a new pediatric outcome measure. Three groups reported early implementation experiences with report cards.
REVAMPING, REPOSITIONING, AND RENAMING HEALTH SERVICES RESEARCH: AHSR's president gave researchers specific assignments of questions to answer, called for a commitment to delivering health care quality information to the public, and invited suggestions to rename the discipline.
卫生服务研究协会（AHSR）于1998年6月21日至23日在华盛顿特区召开了第15届年会“卫生服务研究：对政策、提供和实践的影响”，参会人数创纪录地超过了2100人。会议提供了113场会议，根据十个主题确定了政策圆桌会议以及研究报告和小组会议，其中“质量”主题最为突出，管理式医疗的影响是一个关键问题。本文报道了部分精选演讲内容。
主题演讲“公众与管理式医疗的反弹”在美国塑造公共问题的背景下审视了管理式医疗。新总统的医疗保健行业消费者保护与质量咨询委员会的任务和前景受到了专家和委员会成员小组成员的密切关注。
管理式医疗下的职业道德、态度和实践：关于医生在管理式医疗下是否是“双重代理人”以及考虑到其市场渗透程度管理式医疗如何影响医生的信念和实践等问题出现了相互竞争的观点。
专家们审查了有关实践指南的实施情况、哪种实施方法效果最佳以及如何克服循证指南使用中尚存障碍的证据。临床医生报告了利用协作基准和基于实践的援助成功改善儿童预防服务提供的经验。
小组成员报告了在处理难以衡量的实体方面质量衡量方法的进展，包括一种新的儿科结局衡量标准。三个小组报告了成绩单的早期实施经验。
改革、重新定位和重新命名卫生服务研究：AHSR主席向研究人员提出了需要回答的具体问题，呼吁致力于向公众提供医疗保健质量信息，并邀请大家就重新命名该学科提出建议。
