QUALITY / HYPOTHESES (Q/H)
One of the predominant of the many (for
further information) proposals
to improve health (q/d) care is to change habits. The
concerns are
with the habits of both providers and practitioners in performing
health care and of individuals in their lifestyle.
Provider and practitioner habits are the institutional habits
(e.g. within hospitals)
as well as individual habits (e.g. of physicians). Both of these relate
to the growing interest in (for
further information) practice guidelines and
patient safety, including the I.O.M. reports.
An easy and provocative description of both is "Complications, A
Surgeon's Notes on an Imperfect Science" (Atul Gawande, 2002).
Individual habits relate to the
substantial interest of recent decades in the efforts of public health
agencies and of physicians in disease prevention and health promotion
concerned with (for further
information) individuals'
lifestyles.
Policy, both public and private
(e.g. insurance coverage)
may reinforce the habits or encourage change. For example, policy has
been a primary determinant of end-of-life care, discouraging
non-hospital care by not including it among eligible treatments. The
AcademyHealth
analyzes and outlines best practices for end-of-life and palliative
care
and suggests changes in the policy constraints of present financing
mechanisms:
(for further information) "Financing End-of-Life
Care,
Challenges for An Aging Population" by Austin and Fleisher (2003).