Health Affairs

Posting date: October 7, 2004

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Health Affairs, 10.1377/hlthaff.var.54
Copyright © 2004 by Project HOPE

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Policy Support For Patient-Centered Care: The Need For Measurable Improvements In Decision Quality

Karen R. Sepucha ^1*, Floyd J. Fowler Jr. ², Albert G. Mulley Jr. ³

¹ Karen Sepucha is a senior scientist in the Health Decision Research Unit, Massachusetts General Hospital, in Boston.
² Floyd Fowler is president of the Foundation for Informed Medical Decision Making In Boston.
³ Al Mulley is chief of the General Medicine Division at Massachusetts General Hospital.

^*Corresponding author.

Abstract

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.

Key Words: Chronic Care, Consumer Issues, Quality Of Care, Variations

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