BACKGROUND An increasing number of falls result in an emergency call and the subsequent dispatch of paramedics. In the absence of physical injury, abnormal physiological parameters or change in usual functional status, it could be argued that routine conveyance by ambulance to the Emergency Department (ED) is not the most effective or efficient use of resources. Further, it is likely that non-c...

While consensus has grown that primary care is the essential access point in a high-performing health care system, the current model of primary care underperforms in both chronic disease management and prevention. The Patient Centered Medical Home model (PCMH) is at the center of efforts to reinvent primary care practice, and is regarded as the most promising approach to addressing the burden o...

BACKGROUND In 2008, the Dutch Health Care Transparency Programme (Zichtbare Zorg) was set up to develop and apply quality indicators (QIs) for health care. These QIs serve a range of purposes and can be categorized into those for internal use--for meeting quality standards and to continuously measure improvement (formative)--and external use--to enable patients and health insurance companies to...

The needs assessment process is indeed complex in the social service context. Whereas most contexts can start with a presumption of "no need," the social service context frequently must start with an assumption of "need met-->change." In addition, underlying values--the individual's, the assessor's, the society's--all play a part in the judgment process. The assumption that the involvement of a...

The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outc...

There is a growing health policy mandate for comprehensive monitoring of functional outcomes across post-acute care (PAC) settings. This article presents an empirical comparison of four functional outcome instruments used in PAC with respect to their content, breadth of coverage, and measurement precision. Results illustrate limitations in the range of content, breadth of coverage, and measurem...

BACKGROUND The objective of this article is to describe the design of a study to evaluate the clinical and economic effects of a Disease Management model on functional health, quality of care and quality of life of persons living in homes for the elderly. METHODS This study concerns a cluster randomized controlled clinical trial among five intervention homes and five usual care homes in the N...

BACKGROUND Counselling in primary care settings remains largely unevaluated. Such evaluation has been strongly recommended. AIM To determine the relative effectiveness and cost-effectiveness of generic counselling and usual general practitioner (GP) care for patients with minor mental health problems. METHOD A randomized controlled trial and health economic evaluation were carried out in ni...

Outcomes and effectiveness research is a category of health services research that gauges how well the health care needs of persons with disabilities are being met. Using Patrick's Model of Health Promotion for people with disabilities as a framework for analysis, this article examines outcomes and effectiveness research related to the health care needs of persons with disabilities. The three m...

BACKGROUND Health care regulatory agencies perform audits or inspections to judge the quality and safety of health care. This judgment is based on the assessment of a large set of health care indicators as accepted by the profession. However, there is a lack of knowledge about the influence of these indicators and whether a smaller number would be sufficient for a quality assessment or audit pr...