| Description |
The rise in health care costs, coupled with the increasing demand for a politically eligible proposal, has led to the burgeoning of innovative approaches to health care. To Utahns, the most visible of these policies are President Clinton's American Health Security Act and Governor Leavitt's Utah's Healthprint. This thesis is a consideration of the quality assurance aspects of these proposals using the theoretical accounting model set forth by Robert Anthony in his book Planning and Control Systems: A Framework for Analysis. The focus of this project is to examine who or what links information, in all its forms, to certain people or groups of people, particularly consumers and health care professionals. Commitments to information abound, but the particulars are not clearly defined. Clarification is of special importance because information plays a crucial role in monitoring and improving quality. The rapid changes taking place in health care and health policy makes it necessary for this study to build upon recent analyses and literature, although many of the issues involving quality build upon foundations extending back several years. Informal interviews provided an additional means to tap some of the most current thinking. Proposed and passed legislation also serve as the foundation of this study. Using information to increase quality is a popular topic in the health care industry, but a close examination reveals too few concrete plans to implement information systems. The result is a lack of consistency among health care systems and of control over quality. This thesis asserts that Anthony's model helps reconcile the polarity between decentralization and centralization of information handling. It first suggests that a central defining mission be created through strategic planning, which provides an organization with a common sense of purpose and direction. This analysis further suggests that control of actual health care delivery occur through management control, which is marked by a high degree of individual discretion, rather than operational control, which is driven by rules acquired from other systems. Hence, some degree of decentralization must be reserved for the physician-patient encounter |
