Myths and legends number among the most creative and abundant contributions of Christianity to the history of human culture. They have inspired artists, dramatists, clerics, and others to contemplate the wondrous effects of Christian salvation on the cosmos and its inhabitants. They… The nature, functions, and types of myth Myth has existed in every society. Indeed, it would seem to be a basic constituent of human culture.
Two considerations are useful for context: Measuring quality of care objectively in the U. These beliefs are virtually unchanged since per Gallup. Three reports sparked the birth of the modern quality improvement era in our system almost 20 years ago: And it put an uncomfortable spotlight on unnecessary care and its pervasiveness in our system.
And ina team of RAND researchers found gaps in quality pervasive: We found little difference among the proportion of recommended preventive care provided Among different medical functions, adherence to the processes involved in care ranged from Quality varied substantially according to the particular medical condition, ranging from Strategies to reduce these deficits in care are warranted.
Say it aint so. Can it be that quality is not uniform across the U. Can it be that some doctors get better results than others and some hospitals are safer for patients than others?
Is it true that some approaches to care get better outcomes than others? Inside the industry, these studies and hundreds since have revealed widespread variation in the quality of care we provide our patients.
But the public remains largely unaware, and fewer than one in ten is predisposed to study our methods and results closely. Quality of care in the U.
Data about the healthcare systems in 35 developed countries from the Organization for Economic Cooperation and Development allow comparisons of life expectancy, morbidity, access to providers and admission rates to hospitals among other metrics.
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Supplemental analyses by academics like Robert Blendon and others also provide country comparisons. In these analyses, the U. But these comparisons are misleading.
Beyond the complexity of our pluralistic payment system, there are major differences between the U. De facto, the U. We spend more on the health programs proportionately than other countries and less on the human services programs.
In other countries, safety net services for more directly integrated in their care delivery strategies; in the U. So larger investments in safety net programs in other countries and their integration into their delivery systems are major differences between the U.
The facts are startling: No other country comes close. Most use a strong primary care front door to their system, so preventive health and referrals for specialty care are appropriately maintained. Most have a mechanism whereby decisions about major interventions of guidelines for diagnosing and treatment are evidence-based and followed closely.
Most negotiate with drug, device and technology suppliers directly and get significant discounts vs.
And most have a global budget for their health and human services investments, forcing regulators and providers to establish priorities and address tough decisions about end of life care, the usefulness of costly technologies and more. Public opinion surveys in countries like France, Switzerland, the UK and others show higher levels of satisfaction with their systems that ratings of our system by Americans, so the U.
The quality improvement movement in the U. Clinicians and academicians have improved clinical processes for diagnosing and treating specific patient populations, addressing variability for virtually every diagnosis specific to signs, symptoms, risk factors, patient values and social determinants of their health.
The results of these efforts are clear and positive. Health services researchers have correlated adherence to evidence-based clinical practices with better outcomes and lower costs.
Accreditors and regulators have crafted rules and regulations based on process measures for which hospitals, physicians, and post-acute providers can he held accountable. Government agencies have become more aggressive in scrutinizing quality.
And the sweeping change in incentives for providers from volume to value is premised on the assumption that achieving evidence-based thresholds of quality a basis for participating in savings. All these are derivatives of the quality improvement movement in the U.
The bottom line is this:I used to be one of those people who thought that in order to eat vegan, one must eat rice and beans at each meal.
Does anyone else remember this mumbo jumbo myth, too? While in United States, there is a stringent quality control and a serious periodic monitoring of the quality, this is far from truth in India, where to get a drug license through political or bureaucratic connections by corrupt means is .
Jun 21, · Best Answer: I work closely with India everyday, for the past 4 years. I have not seen proof that their quality has improved one bit over the last few years. My company uses India because they cost 1/3 initiativeblog.com: Resolved.
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By PAUL KECKLEY. According to Gallup surveys, four of five Americans believe the quality of care they receive is good or excellent, and the majority think it is the best available in the world.