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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 ...
Andersen healthcare utilization model. The Andersen healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, the usage of health services (including inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing ...
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.
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 ...
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.
Scientific management is a theory of management that analyzes and synthesizes workflows. Its main objective is improving economic efficiency, especially labor productivity. It was one of the earliest attempts to apply science to the engineering of processes to management. Scientific management is sometimes known as Taylorism after its pioneer ...
The biomedical model of medicine care is the medical model used in most Western healthcare settings, and is built from the perception that a state of health is defined purely in the absence of illness. [ 1]: 24, 26 The biomedical model contrasts with sociological theories of care. [ 1]: 1 [ 2] Forms of the biomedical model have existed since ...
Health policy and management. Health policy and management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks. Health care administrators are considered health care professionals.