Policy support for patient-centered care: the need for measurable improvements in decision quality

• Published in: Health affairs (Millwood, Va.) Vol. Suppl Variation; pp. VAR54 - VAR62
• Main Authors: Sepucha, Karen R, Fowler, Jr, Floyd J, Mulley, Jr, Albert G
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 2004
• Subjects: Breast cancer; Clinical decision making; Clinical medicine; Decision Making; Decisions; Health care; Health care expenditures; Health care policy; Health Knowledge, Attitudes, Practice; Health Policy; Humans; Measurement; Patient-Centered Care; Patients; Physicians; Policies; Practice Patterns, Physicians; Quality; Quality of care; Quality of Health Care; Studies; Surgery; United States; Variances; Variation; United States; United States > US
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.var.54

The phenomenon of practice variation draws attention to the need for better management of clinical decision making as a means of ensuring quality. Different policies to address variations, including guidelines and measures of appropriateness, have had little demonstrable impact on variation itself or on the underlying quality problems. Variations in rates of interventions raise questions about the patient-centeredness of decisions that determine what care is provided to whom. Policies that support the development and routine use of measures of decision quality will provide opportunities to measurably improve the quality of decisions, thereby leading to more patient-centered and efficient health care.