Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 2. Determinants of the Process of Care


This set of concerns involves information that would improve the understanding of how the process of care is ultimately determined. Although structural arrangements may be in place, their influence could depend on whether or how they are understood by physicians and other providers, and on how the providers respond. Structural arrangements may also influence the nature of the provider-patient relationship and process of care. Specific kinds of structural features (e.g., practice guidelines, profiling) are being developed, and there is interest in their effects. Similarly, both consumers with particular health needs and providers focused on serving them are interested in how managed care influences use of provider services. More broadly, there is a concern for knowing the actual use that is made of new technology, since this may influence practice and expenditures. There also is interest in how situations like malpractice can be assessed at the enterprise level rather than just the provider level when managed care and integrated systems are growing. But existing systems do not capture these features of care or the use of particular technologies in a consistent and timely basis.

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