Individual:
- measures of medical services utilization relative to enabling and predisposing factors, while controlling the need for care
- the patient's assessment of the interaction with the provider
Health plan:
- plan characteristics that affect enrollment (such as cost of premium, deductibles, copayments, coverage for preventative care, authorization of new and expensive procedures, physician referral incentives, and
out-of-plan use).
- plan practices that affect access (such as travel time, waiting time, hours of operation, etc.)
- plan quality as measures by the healthcare effectiveness data and information set (HEDIS).
Delivery system:
- comprise ecological measures that affect the populations rather than the individuals. System indicators help researchers study access in an environmental context (health policies/programs related to access, physician-population ratio, hospital beds per
1,000 population, % with insurance coverage, income, etc.).
Structure - foundation of the quality of heath care. Good processes require a good structure (licensing, accreditation, equipment, training, etc.).
Processes - influenced by structure and together they influence quality outcomes (diagnosis, treatment procedures, cost, waiting time, correct prescriptions, etc.).
Outcomes - quality determined by the quality of structures and processes (patient satisfaction, health statues, recovery, improvement, mortality, etc.).
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