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High quality of health care provision portrays the desired health outcomes. It is essential for each health facility to provide high quality care that continuously aims at the maintenance of quality of life. Successively, there is a need to conduct an ongoing ample self-assessment of the quality of care in services provided to patients in the health care centers. As a result, it is decisive to understand the assessment of the quality of care, conceptual framework for quality assessment, sources involved with the public release of information in the Arkansas state. Thereafter, it is indispensable to carry out an analysis of the state data, and finally to provide recommendations on areas of service that need reform in ArkansasState.

Assessment of ArkansasState Quality of Care

It is essential to undertake several steps while assessing the quality of health care. Before an individual carries out an assessment, one must ascertain how broad health and responsibility for health are defined. As a result, the probability of what level of optimally effective care is sought. Therefore, one has to specify the desired outcome of care, formulate the appropriate criteria and standards, and obtain the necessary information (Institute of MedicineU.S. et al., 2001). This mainly involves considering the patient-physician relationship during the consultation process. More significantly, it depicts the procedures a patient goes through in the health care system as he/she seeks medication.

In most cases, a random sampling approach is highly effective, even though it does not cover the whole population of residents in a state. In America, the sampling approach is highly favored as compared to interview approach in the assessment of quality of care in the health sector. With technological advancements, the use of the increasingly sophisticated computerized information systems has considerably enhanced quality of care that patients receive. The sample size of patients should comprise of those from the inpatient, outpatient, and surgical. Firstly, there is a need to ascertain the relation between the patient and the medical practitioners. This can be evaluated through ascertainment of how well doctors and nurses communicate with patients. In addition, an individual can use such measures as the level of responsiveness of hospital staff, communication about medications, and pain management (Institute of MedicineU.S. et al., 2001). Other individual measures such as the level of cleanliness and quietness of the hospital environment also contribute to the quality level of care in a health care institution.

Thereafter, it is necessary to calculate the hospital-level of admission rates. This can be done through an assessment of standardized mortality and readmission rates for several conditions as well as through service claims and enrollment data, and statistical modeling techniques. At this point, the statistical model should be adjusted to patient-level risk aspects, which affect the likelihood of readmission (Institute of MedicineU.S. et al., 2001). These aspects comprise of gender, age, past medical history, among other conditions that could influence resistance to medication. Through the US Department of Health and Human Services, Center for Disease Control (CDC) and the NationalCenter for Health Statistics, one can get the recent research statistics on quality of care in the United States.

Conceptual Framework for Quality Assessment

Reports of findings from studies carried out by the National Health Care Quality Department should comprise of two dimensions. These dimensions include the consumer perspective on health care needs and the components of health care quality. Undertaking Donabedian strategy of assessing quality health care, under the three key elements comprising of structure, process, and outcome, an individual will need to analyze the seven pillars of quality health care assessment.
Under the components of health care quality, it is possible to assess the safety level of health care. This comprises of research carried out on random sampling to assess the efficacy level of medical practitioners to avoid injuries from the intended care. This comprises of procedures that are designed and implemented in the health care process so as to avoid injuries. Thereafter, it is critical to undertake the measure of patient centeredness through acceptability. This is whereby the decision made through the partnership of practitioners, patients, and their families respects the patient’s needs, preferences and wants (Institute of Medicine U.S. et al., 2001). This is achievable through offering patients the necessary information they require in making a decision and even participate in their own care. As a result, the patient becomes prepared for treatment, as all care is centered on the provision of high-quality services.
Timeliness is also another conceptual framework that makes up the components of health care quality. It refers to the level at which an individual can get the essential care as soon as possible such that cases of unnecessary delays when an individual seeks medical care turn out to be minimal. This factor ensures that a patient gets the information on the medical results within a short and appropriate period (Institute of MedicineU.S. et al., 2001). As a result, the patient gets timely care so as to prevent further pain, infection, and side effects. Effectiveness refers to the provision of services based on scientific knowledge. Therefore, it does not allow medical personnel to practice discrimination of patients while offering them the services. This is because it enhances the degree to which attainable health improvements can be easily comprehended.

When it comes to the consumer perspective on health care needs, the measures used for the assessment are in the form of efficiency, equity, optimality, and legitimacy. Efficiency is a component that many consumers consider while seeking medical care. It enhances the ability to obtain the greatest level of health care improvements at a lower cost. In addition, equity is attributed to the lack of discrimination in terms of the quality of health care services offered. This comprises of fairness in the distribution of care in the health sector. The services offered rely on clinical needs rather than racial, gender, ethnicity, insurance coverage, geographical location or socioeconomic status (Institute of Medicine U.S. et al., 2001). Optimality refers to the quality of care that balances the costs and benefits, while legitimacy ensures the conformity of all the conceptual framework components to social preferences.

Sources Involved With the Public Release on Quality in the Arkansas State

In the United States, several agencies carry out public release of the quality of health care in different states. Information about the relative performances of individual physicians, health insurance plans, and hospitals is made public in the United States. Nonetheless, there has been controversy based on the process of disclosure, the content of the data and the related advantages and risks (Medline, 2003). Considerably, the art of information released to the public in the United States is diverse and lacks a principal strategic plan. The National Committee for Quality Assurance (NCQA) is a renowned nonprofit organization that deals with the evaluation of health care quality, especially that of health maintenance organizations (HMOs). Comparative quality information based on health care data can be found on its website: ncqa.org (Medline, 2003). Unlike NCQA, Health Grades is a profit-making company that not only uses its own analyses, but also those of others. The organization presents the comparative information on its website healthgrades.com. Notably, some information can be accessed free of charge, while others need to be purchased.

The National Quality Forum, unlike the other consortiums that produce their own public report, promotes standardized measurement specifications, audit tools, collection, and verification of core sets of quality measures (Medline, 2003). This is availed through its website qualityforum.org. State-based initiatives also play a significant role in giving the information to the public. The Center for Medicare and Medicaid Services (CMS) embarked on an ambitious public reporting project based on the quality care offered in facilities. CMS has shown initiative in the development of report cards that are individual physician-specific. CMS has chosen diabetes care as the first condition it will undertake (Medline, 2003). Finally, the government-sponsored consortium, Consumer Assessment of Health Plans (CAHPS) develops a common survey. The information offered from this survey has shown that in experimental situations, CAHPS information can influence a patient’s choice of providers; nonetheless, real world observational studies have reported mixed results.

An Analysis of Arkansas State Data

A comparison of the Arkansas State data to the United States general data gives a clear indication of the improvement levels of quality care. Unlike the previous years, the percent of Critically Acute Hospital (CAHs) reporting data to the hospital has risen, while comparing varied results across states. More significantly, the Arkansas participation rate in 2009 was 82.8%, which is much higher as compared to the national rate of 72% (Compressed mortality file, 2007). The 2009 rate was greater than the rate in 2008. The number of CAHs in Arkansas (HCAHPS reporting rate is 13.8%) is lower than the national’s (35.4%). In addition, the outpatient data in Arkansas stands at 17.2%; this rate is greater than the concurrent national outpatient rate (15.9%) (CDC: Healthy people data, 2010). In the Arkansas State, 90% of the CAHs have too few cases of reliability, while the other 10% did not have an AMI mortality rate. In the cases of heart failure and pneumonia, mortality rate is 58% and 71% respectively. Cases that had mortality rates that are either worse or better than the US rates for all hospitals indicate less than 1% and 3% of CAHs, which were those of heart failure and pneumonia respectively.

In the Arkansas State, there is a need to ensure that the quality of health care provision is highly esteemed. This is possible through the enhancement of the regulation that emphasizes on the medical practitioners necessity to provide appropriate and professional-quality services to patients. As a result, the state and the Arkansas Department of Health should focus on quality improvement (CDC: Healthy people data, 2010). The agency should ensure that the services provide safe, humane, and appropriate health care.
More significantly, Arkansas State requires a declaration of the use of physician’s incentives arrangement in the quality health care assessment. It is essential to encourage the development, implementation, and maintenance of a continuing program to evaluate and improve the quality of services provided. The quality improvement assessment plan should be reviewed and approved by the medical body annually. Nonetheless, the assessment should focus on ascertaining whether the facilities have well-trained and motivated medical personnel who can provide quality care. Moreover, the federal health care reform and state level reforms should be moving towards health care systems that oversee the provision of high-quality care.

In conclusion, the assessment of the quality of care in the health sector is critical. It is necessary for each state to carry out an ongoing program to assess and enhance the quality of care and services provided. As a result, each health facility will provide high-quality care that continuously aims at the maintenance of quality of life. Therefore, there is a need to formulate rules and regulations that would govern the provision of medical care in the state and would require all the medical practitioners to observe the patients’ right to appropriate and professional-quality services. Without doubt, the quality of care in health facilities should be improved in all states. 

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