miércoles, 25 de junio de 2014

Top-down and bottom-up approaches to ... [Annu Rev Public Health. 2014] - PubMed - NCBI

Top-down and bottom-up approaches to ... [Annu Rev Public Health. 2014] - PubMed - NCBI

AHRQ Study Examines Impact of Regulation and Report Cards

An AHRQ-funded study published in this year’s Annual Review of Public Health examines and contrasts the effects of regulation and public reporting of the quality of care by various providers, including nursing homes, hospitals and physicians. “Top-Down and Bottom-Up Approaches to Health Care Quality: The Impacts of Regulation and Report Cards” is a literature review that explores the effects of both approaches on provider and consumer behavior. The study finds that both approaches can lead to positive impacts as well as some unintended consequences. The study also outlines research gaps that could help inform future research efforts.

See 1 citation found by title matching your search:

 2014;35:477-97. doi: 10.1146/annurev-publhealth-082313-115826. Epub 2013 Oct 23.

Top-down and bottom-up approaches to health care quality: the impacts of regulation and report cards.


The high cost of the US health care system does not buy uniformly high quality of care. Concern about low quality has prompted two major types of public policy responses: regulation, a top-down approach, and report cards, a bottom-up approach. Each can result in either functional provider responses, which increase quality, or dysfunctional responses, which may lower quality. What do we know about the impacts of these two policyapproaches to quality? To answer this question, we review the extant literature on regulation and report cards. We find evidence of both functional and dysfunctional effects. In addition, we identify the areas in which additional research would most likely be valuable.

[PubMed - in process]

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