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PubMed1998

Perversion.

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Humans↗
PubMed1998

High ideals & perverse consequences: risk adjustments, encounter data & Medicare+Choice.

Why should you take on the risks and complications of developing a PSO? Is it worth it? Will it mean assuming undue risk? The answer to this question gets complicated. This article will introduce more uncertainties than you had before. But, you need to have your eyes wide open. It's not just a question of your capability as a health system or a medical group. It's a question of HCFA's ability to administer the program. Even without knowing the capabilities of HCFA, most organizations would say that they don't trust the government to follow through with any program. In this article by Bruce Fried, we get a rare look at the inner thoughts and gyrations of government, as they attempt to risk-adjust Medicare payments to PSOs and HMOs. In ordinary language, that means, if you happen to have a very sick population of seniors, you will be paid more to take care of them. But, read this and weep.

Aged↗
PubMed1981

Softening the 'perverse' effects of quality assurance.

Interdisciplinary stress is a common, though unwelcome, by-product of quality assurance activities. The divergent lines of authority in a hospital are usually inadequate for dealing with interdisciplinary problems or with joint or contested matters, resulting in uneven treatment of those identified as having lapsed from accepted standards. If the purpose of quality assurance--improvement of patient care--is not to be perverted, current methods of dealing with identified problems must be revised.

Conflict, Psychological↗
PubMed1989

Efficiency & perversity in hospital services.

Andrew Green and Stephen Harrison explore some of the ambiguities in the concept of efficiency as it is used in the health service, and argue that under the white paper proposals the pursuit of efficiency will be different but not necessarily better.

Efficiency↗