Appropriateness in health care delivery: definitions, measurement and policy implications
John N. Lavis, MD, MSc; Geoffrey M. Anderson, MD, PhD
Canadian Medical Association Journal 1996; 154: 321-328
Dr. Lavis is from the Division of Health Policy Research and Education, Harvard University, Boston, Mass., and Dr. Anderson is from the Institute for Clinical Evaluative Sciences in Ontario, North York, Ont., and the Department of Health Administration, University of Toronto, Toronto, Ont.
Paper reprints of the full text may be obtained from: Dr. Geoffrey M. Anderson, Institute for Clinical Evaluative Sciences in Ontario, G-106, 2075 Bayview Ave., North York ON M4N 3M3
Abstract
A major focus of the current health care debate is the notion that a substantial proportion of the health care delivered in Canada is inappropriate. There are two types of appropriateness: appropriateness of a service and appropriateness of the setting in which care is provided (i.e., inpatient v. outpatient or home care). Measuring both types objectively requires the comparison of observed patterns of care with explicit criteria for appropriate care. The few studies of appropriateness conducted in Canada have shown that inappropriate services are provided and inappropriate settings are used. Reducing inappropriate health care delivery could involve active strategies for the implementation of guidelines and better cooperation and coordination within the health care system. However, lower rates of health care delivery or even of inappropriate health care delivery will not necessarily translate into higher quality care or lower costs overall.
| CMAJ February 1, 1996 (vol 154, no 3) |