Donabedian Model Of Quality Analysis

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6Q. Donabedian model of quality:
• Donabedian model plays an important role in measuring quality in health care sector.
• The three elements proposed by Donabedian are hierarchical. All the three are of prime importance.
• All of them are interdependent and should be used together to maintain quality of care. (Al-Assaf, 1993).
• The Donabedian model views quality exclusively from a delivery system’s angle. It does not consider social factors, lifestyle, and behavioral factors that have a major effect on the health care delivery system (Shi & Singh, 2015)
The three components of the model are: (Shi & Singh, 2015)
Structure signifies the capacity to yield quality.
Process conveys how health care is provided.
Outcome defines the results.
1. Structure:
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• State licensure in general is not related directly to the quality of care actually delivered by health care facility.
• It highlights physical plant compliance with building codes fire safety climate control space allocations sanitation (Rooney, 1999).
• Licensure is managed by state well-being departments.

Certification:

• Certification is usually defined as the process with the help of which an authorized body, which can be either a governmental or non-governmental organization, assesses and identifies a hospital as gathering pre-determined requirements or standards (Rooney. 1999).
• It is not compulsory that means it is necessary only when a hospital wants to take part in Medicare and Medicaid (Shi & Singh, 2015).
• Hospitals must generally obey with the rules and regulations of participation—federal standards for well-being, security, and health care quality.
• Organizations that have a certification are approved by other organizations, for example International Organization for Standardization (ISO) (Rooney, 1999).
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• The utmost challenges that are posed by the health care delivery systems are greater rise in costs, absence of access, and quality concerns.
• All these three important cornerstones of health care delivery are interdependent (Al-Assaf, 1993a). This is because it may be able to improve one or perhaps even two of the three, but it will only come at the expense of the third. By reducing the health care costs, it ultimately results in either reduced quality of care, or decreased access to care, or it can lead to decline in both. In the similar way, attempts to improve quality can either escalate the costs, or decreases access (Riner, 2012). Therefore, all the three dimensions must be utilized together to maintain the delivery of health care.
Significance of each parameter:
Access:
• Access refers to enabling all citizens to attain health care services whenever necessary.
• Access is a major standard in evaluating the efficacy of health care delivery system.
• It is the significant determinant of health and is often related to the quality of care and efficient use of services necessary (Shi & Singh, 2015).

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