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An eclectic approach to quality control in fee for service health care: the New York City Medicaid experience

Author

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  • Rosenberg, S.N.
  • Gunston, C.
  • Berenson, L.
  • Klein, A.

Abstract

A computer based system for evaluating the quality of fee for service health care in the New York City Medicaid Program is described. Specific information is sought for use in educational, enforcement and managerial activities to improve health care quality. The gathering of this information necessitates coordinated assessment of the structure, process and outcome of health care, through inspection of offices, computerized analysis of patterns of practice as revealed by billing forms, and reexamination of patients. The program's focus on patterns of practice, its use of multiple assessment techniques, and its concentration on unequivocally substandard care circumvent several limitations on current evaluation technology. Implications for Professional Standards Review Organizations and national health insurance are explored.

Suggested Citation

  • Rosenberg, S.N. & Gunston, C. & Berenson, L. & Klein, A., 1976. "An eclectic approach to quality control in fee for service health care: the New York City Medicaid experience," American Journal of Public Health, American Public Health Association, vol. 66(1), pages 21-30.
    • Handle: RePEc:aph:ajpbhl:1976:66:1:21-30_2
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    Cited by:

    1. Suffczyński, M. & Kunert, H., 1982. "Coupling coefficients for the irreducible representations of the space group of garnet," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 114(1), pages 596-599.

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