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Donabedian model. The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care. [ 1] According to the model, information about quality of care can be drawn from three categories: “structure,” “process,” and “outcomes." [ 2] Structure describes the context in ...
Utilization management. Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its appropriateness before it is provided using evidence-based criteria or guidelines.
Increasing or decreasing one results in changes to one or both of the other two. For example, a policy that increases access to health services would lower quality of health care and/or increase cost. The desired state of the triangle, high access and quality with low cost represents value in a health care system.
A time and motion study (or time-motion study) is a business efficiency technique combining the Time Study work of Frederick Winslow Taylor with the Motion Study work of Frank and Lillian Gilbreth (the same couple as is best known through the biographical 1950 film and book Cheaper by the Dozen ). It is a major part of scientific management ...
Uncertainty management theory ( UMT ), developed by Dale Brashers, addresses the concept of uncertainty management. Several theories have been developed in an attempt to define uncertainty, identify its effects and establish strategies for managing it. [ 1] Uncertainty management theory was the first theory to decline the idea that uncertainty ...
Complexity theory emphasizes interactions and the accompanying feedback loops that constantly change systems. While it proposes that systems are unpredictable, they are also constrained by order-generating rules. [6]: 74 Complexity theory has been used in the fields of strategic management and organizational studies.
According to Dr. Relman, American health care system is a profit-driven industry and it has become a widely accepted theory these days. [10] Since the term was introduced 40 years ago, health care industry has developed into even a larger, greater and flourishing industry.
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American ...