Data Council (web site)

B. Structural Data Gaps: Suggestions for Action

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. B. Structural Data Gaps: Suggestions for Action

There is a need for much more information that could be used to describe the health system both in terms of function and in how the relationships of its components are evolving in an era of consolidation, integration, and managed care. The needs in this area correspond to the resource and structural issues we discussed, and to the related concerns

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. A. A General Role and Need for HHS

Private sector actors and states alone cannot address the concerns we identified. The private sector lacks the potential for generating legislative authority to require compliance that is inherent in government. Also--and perhaps of greater relevance--the private sector does not perceive itself to have the resources or scope of influence over comp

V. IMPLICATIONS FOR HHS AND PRIORITY EFFORTS

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. V. Implications for HHS and Priority Efforts

KEY POINTS

B. Impetus for Efforts and Their Constraints

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. B. Impetus for Efforts and Their Constraints

Table 8 categorizes the impetus for and the information needs that were the focus of each of the 11 efforts we studied in depth. Also presented are perceived barriers to carrying out the efforts. The 11 efforts can be viewed as spanning the continuum of structure, process, and outcomes of care.

A. Focus and Content of Data Collection Efforts

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. A. Focus and Content of Data Collection Efforts

In the first phase, we identified 23 efforts that fell within the scope of our study and into one of three groupings. One grouping is of on-going national efforts, the second is of other national efforts, and the third involves other more limited efforts but still of interest nationally. In the second phase, we obtained more information on 11 of t

IV. EXTENT TO WHICH GAPS ARE BEING ADDRESSED:

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. IV. Extent to Which Gaps are Being Addressed: What We Learned

KEY POINTS

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. F. Summary List of Key Data Gaps

Table 6 summarizes key data gaps by type that stakeholders perceive in today’s market. Note that a “data gap” is not synonymous with an “information need”. In practice, information needs are met by merging multiple kinds of data to answer a question. Thus, an absent core data element (like transaction and service based information on enc

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. E. Cross-Cutting Issues and Needs

A number of information needs expressed by respondents were more general and cut across the specific substantive questions and needs discussed thus far. These needs are reflected in the following questions:

3. Population-Based Information on Access and

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 3. Population-Based Information on Access and Distribution

The shifts in the system are generating needs for population-based information about access and distribution. A key concern of a number of groups and individuals we interviewed involves whether one could be confident that existing information would show whether individuals are being squeezed out of the health system. Historically, hospital data on

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

There is considerable interest in understanding cost trends, particularly with the shift toward managed care and more ambulatory based delivery using competitive models. Current spending categories provide limited insight on key questions. For example, consolidation is occurring with managed care, but existing systems provide only limited informat

1. Appropriateness of Care and Clinical Outcomes

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 1. Appropriateness of Care and Clinical Outcomes

A key set of outcomes-related concerns has to do with how to interpret practice. For example, is a C-section rate too high or too low when it falls or is below average? Some standard for comparison or form of analysis is needed to interpret change. For example, if care processes are subject to strict clinical and utilization management oversight i

D. Assessing Issues and Needs: Outcomes of

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. D. Assessing Issues and Needs: Outcomes of Delivery and Policy

Information on outcomes of the health care system have historically been among the least developed. In today’s environment, this kind of information is increasingly valued both by those concerned with assessing the value of care and by those concerned with understanding its costs and distributional implications. Table 5 summarizes questions in e

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 3. Efficiency in the Process of Care

In a competitive marketplace, provider groups want better information on how they perform relative to their competition. This may be providers like them (e.g., other group practices) or other entities (e.g., academic medical centers or public hospitals). Purchasers also want to compare performance of plans on various measures of financial, quality

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 als

1. Structure and Responsibility for Process of

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 1. Structure and Responsibility for Process of Care

Existing data systems provide little insight into which health plans even operate, let alone how they do so and what this implies for the various actors in the system. Thus, a high priority for many different entities is information that would shed light on these issues and on what they mean for a diverse variety of functions these entities perfor

C. Assessing Issues and Needs: Operational

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. C. Assessing Issues and Needs: Operational Performance and the Process of Health Care Coverage and Delivery

The issues and needs associated with the process of care can be classified in three categories: (1) better knowledge of the structure of and responsibility for the process of care, (2) the determinants of the process of care, and (3) the efficiency of the process of care both generally and relatively across participants. Table 4 summarizes the key

2. Structure II: Resources -- Training and

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 2. Structure II: Resources -- Training and Financing

Information on resources involves questions and concerns that are central to the development and financing of the system and its components over time (see Table 3 for illustrative issues). Interviewees were especially concerned about training for providers, especially physicians, given the fact that there is already an oversupply nationwide. Many

1. Structure I: Providers, Linkages, Continuum of

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 1. Structure I: Providers, Linkages, Continuum of Care

Most of the current information on the structure of the health system is oriented toward the counting of the individual types of resources (like providers, facilities or health plans) that make up the structure. In contrast, our project showed that there is a need for information that would allow one to interpret the adequacy or change in these re

B. Assessing Emerging Issues and Needs: Health

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. B. Assessing Emerging Issues and Needs: Health Care Structure

The structure of the health care system reflects the individual providers as well as how they are organized and linked together as a delivery and financing system, and how well they are linked across the continuum of care. In addition, the number and kinds of physicians in practice reflects the time lag associated between provider training and act

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. 2. How Good Has the Information Been?

Periodic reviews have been conducted to develop information and/or consensus on the adequacy of available information. Federal data, more than state data, have been subject to review, although there is some information on state data. Reports assessing data collected by private-sector groups are less likely to be publicly available. Most assessment

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