Effectiveness Of Internal Programs In Improving Quality And Reducing Costs. Results From A Randomized Study

Saturno PJ, Gascon JJ and Anton JJ.
University of Murcia. Murcia (Spain).
Objectives. To assess the effect of internal commitment to quality. Methods. A sample of 9 Health Centres (HCs) were randomly assigned to three groups: training and internal commitment on quality (Group 1); HCs receiving feed-back from external evaluations (Group 2) and a control group (Group 3). Process of care and treatment cost for common cold patients were evaluated before and after interventions in a random sample of 50 patients from each HC. Measurements in Group 1 were made internally and also externally by the same external reviewer who audited Group 2 and Group 3. Cost information was assessed only externally, and was not included in the information feed-back. HCs were not aware of the study objectives.
Results. Group 1 showed significant improvement in all the three assessed criteria and average treatment cost decreased by 30% (p Conclusions. Internally assumed quality improvement activities are significantly more effective than external feed-back of evaluation results. Besides, cost of deficient quality has revealed to be so high that there is a wide margin for health authorities to invest with benefits in the promotion of internal quality improvement programs.
Effectiveness of internal programs in improving quality and reducing costs. Results from a randomized study