Be. Landon et al., A CONCEPTUAL-MODEL OF THE EFFECTS OF HEALTH-CARE ORGANIZATIONS ON THEQUALITY OF MEDICAL-CARE, JAMA, the journal of the American Medical Association, 279(17), 1998, pp. 1377-1382
There has been a great deal of interest in recent years in developing
measures of health care quality that can be used to characterize and s
tudy the effects of health plans. However, because of the recent emerg
ence of diverse types of health care organizations, it is often diffic
ult to know which parts of a plan should be combined for analysis purp
oses. Also, simple taxonomies of health maintenance organizations (eg,
staff, independent practice associations, group, and network) no long
er adequately describe the diverse types of organizations that have be
come common. In this article we describe these trends, explain why old
er taxonomies of health care plans are not adequate, and present a new
framework for characterizing and studying the effects of diverse type
s of plans.