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The structured what-if technique (SWIFT) is a prospective hazards analysis method that uses structured brainstorming with guidewords and prompts to identify risks, [1] with the aim of being quicker than more intensive methods like failure mode and effects analysis (FMEA).
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
Health care quality is the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes. [2] Quality of care plays an important role in describing the iron triangle of health care relationships between quality, cost, and accessibility of health care within a community. [3]
A health risk assessment (HRA) is a health questionnaire, used to provide individuals with an evaluation of their health risks and quality of life. [5] Commonly a HRA incorporates three key elements – an extended questionnaire, a risk calculation or score, and some form of feedback, i.e. face-to-face with a health advisor or an automatic online report.
Examples include identifying high-risk pregnancies in order to ensure appropriate pre-natal care and watching for dialysis claims to identify patients who are at risk of end-stage renal disease. The amount of involvement an insurer can have in managing high cost cases depends on the structure of the benefit plan.
The c. 1847 work of Ignaz Semmelweis on the association between puerperal fever and the absence of aseptic procedures (specifically, doctors who failed to clean their hands before delivering babies) and the subsequent use of calcium hypochlorite to reduce risk, is an early example of outcomes research.
Even with the expanded access to preventative care services and other healthcare related services, the insured still experience rationing due to increasing premiums and rising healthcare costs. From 2005 to 2015, the average annual employer-sponsored health insurance premiums for family coverage increased 61%.
Iconographic Collections. Keywords: E. Walker; Florence Nightingale; W.J. Simpson. Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks in all the primary, secondary, and tertiary sectors.