THE CLINICAL-PRACTICE IMPROVEMENT (CPI) MODEL AND HOW IT IS USED TO EXAMINE THE AVAILABILITY OF PHARMACEUTICALS AND THE UTILIZATION OF AMBULATORY HEALTH-CARE SERVICES IN HMOS - RESULTS FROM THE MANAGED CARE OUTCOMES PROJECT (MCOP)
Sd. Horn, THE CLINICAL-PRACTICE IMPROVEMENT (CPI) MODEL AND HOW IT IS USED TO EXAMINE THE AVAILABILITY OF PHARMACEUTICALS AND THE UTILIZATION OF AMBULATORY HEALTH-CARE SERVICES IN HMOS - RESULTS FROM THE MANAGED CARE OUTCOMES PROJECT (MCOP), PharmacoEconomics, 10, 1996, pp. 50-55
Many American healthcare facilities have come to understand that quali
ty controls cost. Clinical practice improvement (CPI) is a methodology
that creates a clinical laboratory, built into the everyday practice
setting, to find and test best practices. A CPI study is an analysis o
f the content and timing of individual steps in a medical care process
aimed at producing better clinical outcomes for the least necessary c
ost over the continuum of a patient's care. Statistical regression ana
lyses are used to determine whether and how much a particular step act
ually improves medical outcomes. Systematic determination of individua
l process steps that improve medical outcomes is the best way to devel
op demonstrably better care and practice. Combining CPI methodology an
d a data monitor creates a dynamic environment ill which all patient e
ncounters potentially contribute to improving the process of care. We
describe a recent multisite study: the Managed Care Outcomes Project (
MCOP). The MCOP study design permits us to compare the effects of vari
ous pharmaceutical treatments on resource utilisation in actual practi
ce in managed-care organisations. The MCOP database is an important re
source for developing information required to design systems-based dis
ease management programmes.