An Introduction to Quality Assurance in Mental Health

  • Alex R. Rodriguez


Among the most frequently encountered terms in the health services’ literature and at meetings of various health professional disciplines is quality assurance. Since the early 1970s, the term has spread well beyond the health sciences to other fields, so that now it serves as a common term of reference for both principles and activities that reflect professional attention to quality services. In this context, quality assurance has come to represent the profession’s attention to its innate concern about quality services reflected in professional ethics, identity, science, and training. It has thus become contiguous with professionalism and serves as a cornerstone and touchstone for professional commitment to quality and service.


Mental Health Quality Assurance Mental Health Care England Journal American Medical Association 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abram, M. (1984, September). Paper presented at the meeting of the Blue Cross and Blue Shield Association, Annual Medical and Dental Directors’ Conference, Chicago.Google Scholar
  2. Acceptance growing for new utilization tools—AEP and NAP. (1982, October). Hospital Peer Review, pp. 117-121.Google Scholar
  3. Alger, I. (1980). Accountability: Human and political dimensions. American Journal of Orthopsychiatry, 50, 388–393.PubMedCrossRefGoogle Scholar
  4. American Academy of Child Psychiatry. (1983). Child psychiatry: A plan for the coming decades. Washington, DC: Author.Google Scholar
  5. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington, DC: Author.Google Scholar
  6. American Psychiatric Association, (1985). Manual of psychiatric peer review (3rd ed.). Washington, DC: Author.Google Scholar
  7. American Psychological Association. (1980). APA/CHAMPUS outpatient psychological peer review manual. Washington, DC: Author.Google Scholar
  8. Anderson, D.W., & Shields, M.S. (1982). Quality measurement and control in physician decision-making: State of the art. Health Services Research, 17, 124–156.Google Scholar
  9. Atchinson, T.A., & Brooks, E.T. (1981). Centralized continuing education programs. Quality Review Bulletin, 7(1), 13–16.Google Scholar
  10. Barnett, G.O., Winickoff, R., Dorsey, J.L., Morgan, M.M., & Lurie, R.S. (1978). Quality assurance through automated monitoring and concurrent feedback using computer-based medical information system. Medical Care, 16, 962–970.PubMedCrossRefGoogle Scholar
  11. Bassuk, E.L., Rubin, L., & Lauriat, A. (1984). Is homelessness a mental health problem? American Journal of Psychiatry, 141, 1546–1550.PubMedGoogle Scholar
  12. Bauseil, R.B. (1983a). Quality assurance: An overview. Evaluation and the Heath Professions, 6, 139–255.CrossRefGoogle Scholar
  13. Bauseil, R.B. (1983b). Quality assurance methods. Evaluation and the Health Professions, 6, 259–375.CrossRefGoogle Scholar
  14. Bayer, R., Callahan, D., Fletcher, J., Hodgson, T., Jennings, B., Monsees, D., Sieverts, S., & Veatch, R. (1983). The care of the terminally ill: Morality and economics. New England Journal of Medicine, 309, 1490–1494.PubMedCrossRefGoogle Scholar
  15. Bedrosian, J.C. (1983, December). Market forces creating change, absent a national health policy. Financier, pp. 51-54.Google Scholar
  16. Biegel, A., & Sharfstein, S.S. (1984). Mental health care provides: Not the only cause or only cure for rising costs. American Journal of Psychiatry, 141, 668–672.Google Scholar
  17. Blendon, R.J., & Rogers, D.E. (1983). Cutting medical care costs. Journal of the American Medical Association, 250, 1880–1885.PubMedCrossRefGoogle Scholar
  18. Borchardt, P.J. (1981). Nonacute profiles: Evaluation of physicians’ nonacute utilization of hospital resources. Quality Review Bulletin, 7(11), 21–26.PubMedGoogle Scholar
  19. Borenstein, D.B. (1985). Confidentiality. In J. Hamilton (Ed.)., Psychiatric peer review. Washington, DC: American Psychiatric Press.Google Scholar
  20. Bowman, J.G. (1920). Hospital standardization series—General hospitals of 100 or more beds: Report for 1919. Bulletin of the American College of Surgeons, 4, 3–36.Google Scholar
  21. Brewster, A.C., Jacobs, C.M., & Bradbury, R.C. (1984). Classifying severity of illness by using clinical findings. Health Care Financing Review, 6, 107–108.Google Scholar
  22. Brook, R.H. (1977). Quality: Can we measure it? New England Journal of Medicine, 296, 170–172.PubMedCrossRefGoogle Scholar
  23. Brook, R.H., Kamberg, C., & Lohr, K.N. (1982). Quality assessment in mental health. Professional Psychology, 13, 34–39.CrossRefGoogle Scholar
  24. Brook, R.H., & Lohr, K.N. (1981). Quality of care assessment: Its role in the 1980s. American Journal of Public Health, 71, 681–682.PubMedCrossRefGoogle Scholar
  25. Brook, R.H., Williams, K.N., & Davies-Avery, A. (1976). Quality assurance today and tomorrow: Forecast for the future. Annals of Internal Medicine, 85, 809–817.PubMedCrossRefGoogle Scholar
  26. Chassin, M.R. (1983). Variations in hospital length of stay: Their relationships to health outcomes (Office of Technology Assessment, Technology Case Study No. 24). Washington, DC: U.S. Government Printing Office.Google Scholar
  27. Codman, E.A. (1916). A study in hospital efficiency. Boston: Thomas Todd.Google Scholar
  28. Cold, J. (1984). How many psychiatric patients in prison? British Journal of Psychiatry, 145, 78–86.CrossRefGoogle Scholar
  29. Commission on Professional and Hospital Activities. (1985). Length of stay by diagnosis, United States, 1984 (north central region, northeastern region, southern region, western region). Ann Arbor, MI: Author.Google Scholar
  30. Council on Medical Service. (1983). Effects of competition in medicine. Journal of the American Medical Association, 249, 1864–1868.CrossRefGoogle Scholar
  31. Cousins, N. (1985). How patients appraise physicians. New England Journal of Medicine 313, 1422–1424.PubMedCrossRefGoogle Scholar
  32. Cunningham, L.S. (1981). Early assessment for discharge planning. Quality Review Bulletin, 7(10), 11–13.PubMedGoogle Scholar
  33. Davidson, J. (1986, March 5). Research mystery: Use of surgery, hospitals vary greatly by region. Wall Street Journal, p. 35.Google Scholar
  34. Davis, E.C. (1983, December). Local coalitions best hope to control delivery costs. Financier, pp. 27-30.Google Scholar
  35. Department of Health, Education and Welfare. (1975). Forward plan for health: 1977-1981. Washington, DC: U.S. Government Printing Office.Google Scholar
  36. Donabedian, A. (1968). Promoting quality through evaluating the process of patient care. Medical Care, 6, 181–202.CrossRefGoogle Scholar
  37. Donabedian, A. (1978). The quality of medical care. Science, 200, 856–864.PubMedCrossRefGoogle Scholar
  38. Donabedian, A. (1980). The definition of quality and approaches to its assessment. Ann Arbor, MI: Health Administration Press.Google Scholar
  39. Donabedian, A. (1982). Explorations in quality assessment and monitoring: The criteria and standards of quality. Ann Arbor, MI: Health Administration Press.Google Scholar
  40. Donabedian, A. (1984). Quality, costs and cost containment. Nursing Outlook, 32, 142–145.PubMedGoogle Scholar
  41. Doubilet, P., Weinstein, M.C., & McNeil, B.J. (1986). Use the misuse of the term “cost effective” in medicine. New England Journal of Medicine, 314, 253–255.PubMedCrossRefGoogle Scholar
  42. Dramatic variations in medical practice blamed for misspent health dollars. (1984, August 13). Medical World News, pp. 18-19.Google Scholar
  43. Duncan, A. (1980). Quality assurance: What now and where next? British Medical Journal, 180 300–302.CrossRefGoogle Scholar
  44. Eden, H.S., & Eden, M. (1979). Microprocessor-based intelligent machines in patient care. Washington, DC: National Institutes of Health.Google Scholar
  45. Eisenberg, B.S. (1984). Diagnosis-related groups, severity of illness, and equitable reimbursement under Medicare. Journal of the American Medical Association, 252, 645–646.CrossRefGoogle Scholar
  46. Eisenberg, J.M. (1979). Sociologic influences on decision-making by clinicians. Annals of Internal Medicine, 90, 957–964.PubMedCrossRefGoogle Scholar
  47. Eisenberg, J.M., & Williams S. V. (1981). Cost containment and changing physician’s practice behavior. Journal of the American Medical Association, 246, 2195–2201.PubMedCrossRefGoogle Scholar
  48. Englehart, J.K. (1984). Opinion polls on health care. New England Journal of Medicine, 310, 1616–1620.CrossRefGoogle Scholar
  49. Ertel, P.Y., & Alredge, M.G., (1977). Medical peer review: Theory and practice. St. Louis: C. V. Mosby.Google Scholar
  50. Evans, R.W. (1983). Health care technology and the inevitability of resource allocation and rationing decisions. Journal of the American Medical Association, 249 2208–2219.PubMedCrossRefGoogle Scholar
  51. Farrington, J., Flech, W., & Hare, R. (1984). Sounding board: Quality assurance. New England Journal of Medicine, 303, 154–156.CrossRefGoogle Scholar
  52. Fielding, J.E. (1984). Corporate health management. Menlo Park, CA: Addison-Wesley Publishing.Google Scholar
  53. Flagg, D.C. (1985, October). A business perspective on the future of health care. American College of Utilization Review Physicians Newsletter, pp. 1–2, 7-8.Google Scholar
  54. Flexner, A. (1910). Medical education in the United States and Canada. New York: Carnegie Foundation for the Advancement of Teaching.Google Scholar
  55. Forquer, S.L., & Anderson, T.B. (1982). A concerns-based approach to the implementation of quality assurance programs. Quality Review Bulletin, 8(4), 14–19.PubMedGoogle Scholar
  56. Frank, J.D. (1975). Evaluation of psychiatric treatment. In A.M. Freedman, H.I. Kaplan, & B.J. Sadock (Eds.), Comprehensive textbook of psychiatry/II (2nd ed., Vol. 2, pp. 2010-2014). Baltimore, MD: Williams & Wilkins.Google Scholar
  57. Frank, R.G., & Kamlet, M.S. (1985). Direct costs and expenditures for mental health care in the United States in 1980. Hospital and Community Psychiatry, 3, 165–168.Google Scholar
  58. Frank, R.G., & Lave, J.R. (1985). A plan for prospective payment for inpatient psychiatric care. Hospital and Community Psychiatry, 36, 775–776.PubMedGoogle Scholar
  59. Freedman, R.I., & Moran, A. (1984). Wanderers in a promised land: The chronically mentally ill and reinstitutionalization. Medical Care, 22(12, Suppl.), 1–56.Google Scholar
  60. Fuchs, V. (1982). The battle for control of health care. Medical Director, 8(6), 5–9.Google Scholar
  61. Furrow, B.R. (1983, Fall). Will psychotherapy be transformed in the 1980s? Law Medicine and Health Care, p. 96.Google Scholar
  62. Gatekeeper payment system could result in lower quality of care. (1984, May). Hospital Peer Review, p. 61.Google Scholar
  63. Gaumer, G.L. (1984). Regulating health professionals: A review of the empirical literature. Milbank Memorial Fund Quarterly—Health and Society, 62, 380–416.PubMedCrossRefGoogle Scholar
  64. General Accounting Office. (1982). Physician cost containment training can reduce medical costs(GAO/HRD Publication No. 82-36). Washington, DC: U.S. Government Printing Office.Google Scholar
  65. General Accounting Office. (1983). GAO finds many ancillary services unnecessary(GAO/HRD Publication No. 83-74). Washington, DC: U.S. Government Printing Office.Google Scholar
  66. Gibson, R. (1985). The future of the practice of psychotherapy. Psychiatric Hospital, 16, 155–159.PubMedGoogle Scholar
  67. Gibson, R. & Singhas, P. (1978). Professional accountability and peer review. In G. U. Balis (Ed.), The behavioral and social sciences and the practice of medicine. Woburn, MA: Butterworth.Google Scholar
  68. Ginsburg, P.B., & Sloan, F.A. (1984). Hospital cost shifting. New England Journal of Medicine, 310, 893–898.PubMedCrossRefGoogle Scholar
  69. Ginzberg, E. (1975). Notes on evaluating the quality of medical care. New England Journal of Medicine, 292, 366–368.PubMedCrossRefGoogle Scholar
  70. Ginzberg, E. (1983). The grand illusion of competition in health care. Journal of the American Medical Association, 249, 1857–1859.PubMedCrossRefGoogle Scholar
  71. Ginzberg, E. (1984). The monetarization of medical care. New England Journal of Medicine, 310, 1162–1165.PubMedCrossRefGoogle Scholar
  72. Glick, I.D. (1985, May). Quality treatment and practitioner competence.Paper presented at the meeting of the American Psychiatric Association, Dallas.Google Scholar
  73. Goldfarb, D.L., Mintz, R., & Yeager, M.S. (1982). Why did hospital costs increase in 1981? Hospitals, 16, 109–114.Google Scholar
  74. Goldschmidt, P.G. (1982). Health 2000. Baltimore: Policy Research.Google Scholar
  75. Gonnella, J.S. (1983). Clinical criteria for disease staging. Santa Barbara, CA: SysteMetrics.Google Scholar
  76. Gonnella, J.S., Hornbrook, M.C., & Louis, D.Z. (1984). Staging of disease: A case mix measurement. Journal of the American Medical Association, 251, 637–544.PubMedCrossRefGoogle Scholar
  77. Gordon, R.E., Jardiolin, P., & Gordon, K.K. (1985a). Predicting length of hospital stay of psychiatric patients. American Journal of Psychiatry, 142, 235–237.PubMedGoogle Scholar
  78. Gordon, R.E., Vijay, J., Sloate, S.G., et al.(1985b). Aggravating stress and functional level as predictors of length of psychiatric hospitalization. Hospital and Community Psychiatry, 36, 773–774.PubMedGoogle Scholar
  79. Greenfield, W.M. (1983). New approaches to using the determination-of-need process to contain hospital costs. New England Journal of Medicine, 309, 372–374.PubMedCrossRefGoogle Scholar
  80. Greenspan, J. (1980). Accountability and quality assurance in health care. Baltimore: Charles Press.Google Scholar
  81. Grimaldi, P.L., & Micheletti, J.A. (1984). Utilization and quality review under the prospective rate system. Quality Review Bulletin, 10(2), 30–37.PubMedGoogle Scholar
  82. Guttentag, M., & Struening, E.L. (Eds.). (1975). Handbook of evaluation research (Vol. 2). Beverly Hills, CA: Sage.Google Scholar
  83. Hamilton, J. (Eds.). (1985). Psychiatric peer review: Prelude and promise. Washington, DC: American Psychiatric Press.Google Scholar
  84. Hart, D.K., & Hart, J.D. (1980). Hospitals and economic turbulence in the 1980s. Journal of Contemporary Business, 9, 97–110.Google Scholar
  85. Hedlund, J., Viowig, B., Evenson, C., et al.(1979). Mental health infomation systems: A state of the art report. Columbia: University of Missouri.Google Scholar
  86. Henisz, J.E., Levine, M.S., & Etkin, K., (1981). The psychiatric record and quality review. In C. Siegel & S.K. Fischer (Eds.), Psychiatric records in mental health care. New York: Brunner/Mazel.Google Scholar
  87. Hetherington, R. (1982). Quality assurance and organizational effectiveness in hospitals. Health Services Research, 17, 185–201.PubMedGoogle Scholar
  88. Hiller, M.D., & Beyda, V. (1981). Computers, medical records and the right to privacy. Journal of Health Politics, Policy and the Law, 6, 463–487.CrossRefGoogle Scholar
  89. Hiller, M.D., & Seidel, L.F. (1982). Patient care management systems, medical records and privacy: A balancing act. Public Health Reports, 97, 332–345.PubMedGoogle Scholar
  90. Horn, S.D., Chachich, B., & Clopton, C. (1983a). Measuring severity of illness: A reliability study. Medical Care, 21, 705–714.PubMedCrossRefGoogle Scholar
  91. Horn, S.D., Sharkey, P., & Bertram, D.A. (1983b). Measuring severity of illness: Homogeneous case mix group. Medical Care, 21, 14–25.PubMedCrossRefGoogle Scholar
  92. Horn, S.D., Sharkey, D., Chambers, A.F., & Horn, R.A. (1985). Severity of illness within DRGs: Impact on prospective payment. American Journal of Public Health, 75, 1195–1197.PubMedCrossRefGoogle Scholar
  93. Hospital costs for psychiatric care up sharply. (1983, June 6). American Medical News, p. 7.Google Scholar
  94. Houpt, J.L., Orleans, C.S., George, L.K., & Brodie, H.K. (1979). The importance of mental health services to general health care. Cambridge, MA: Ballinger.Google Scholar
  95. Hubbard, J.P., Levit, E.J., Schumacher, C.F., & Schnabel, R.G. (1965). An objective evaluation of clinical competence. New England Journal of Medicine, 272, 1321–1328.PubMedCrossRefGoogle Scholar
  96. Hunt, K. (1983, June 27). Who’ll decide which patients you hospitalize? Medical Economics, pp. 153-159.Google Scholar
  97. Industries use preadmission screening to cut hospitalization. (1982, January). Hospital Peer Review, pp. 1-2.Google Scholar
  98. Jackson, J. (1969). Factors affecting the treatment environment. Archives of General Psychiatry, 21, 39–45.PubMedCrossRefGoogle Scholar
  99. Jencks, S.F., Goldman, H.H., & McGuire, T.G. (1985). Challenges in bringing exempt psychiatric services under a prospective payment system. Hospital and Community Psychiatry, 36, 764–769.PubMedGoogle Scholar
  100. Jessee, W.F. (1977). Quality assurance systems: Why aren’t there any? Quality Review Bulletin, 3(11), 16–26.PubMedGoogle Scholar
  101. Jessee, W.F. (1981). Approaches to improving the quality of health care: Organizational change. Quality Review Bulletin, 7(7), 13–18.PubMedGoogle Scholar
  102. Jessee, W.F. (1983). Assuring the quality of health care: Policy and perspectives. In C. Sager & L.C. Jain (Eds.), Policy issues in personal health services Rockville, MD: Aspen.Google Scholar
  103. Jessee, W.F., & Brenner, L.H. (1982). Approaches to improving health care: Dealing with the problem physician. Quality Review Bulletin, 8(1), 11–14.PubMedGoogle Scholar
  104. Joint Commission on Accreditation of Hospitals. (1985). Accreditation manual for hospitals. Chicago: Author.Google Scholar
  105. Kane, R.A. (1981). Assuring quality of care and quality of life in long term care. Quality Review Bulletin, 7(10), 3–10.PubMedGoogle Scholar
  106. Kapp, M.B. (1984, December). Legal and ethical implications of health care reimbursement by diagnosisrelated groups. Law Medicine and Health Care, pp. 245-253.Google Scholar
  107. Kinzer, D.M. (1983). Massachusetts and California—Two kinds of hospital cost control. New England Journal of Medicine, 308, 838–841.PubMedCrossRefGoogle Scholar
  108. Kohlmeier, L.M. (1983, December). Question of morality, economics now also confront U.S. medicine Financier, pp. 9-13.Google Scholar
  109. Kreitzer, S.L., Loebner, E.S., & Roveti, G.C. (1982). Severity of illness: The DRGs’ missing link? Quality Review Bulletin, 8(5), 21–33.PubMedGoogle Scholar
  110. Lamb, H.R. (1984). Deinstitutionalization and the homeless mentally ill. Hospital and Community Psychiatry, 35, 899–907.PubMedGoogle Scholar
  111. Leaf, A. (1984). The doctor’s dilemma—and society’s too. New England Journal of Medicine, 310, 718–720.PubMedCrossRefGoogle Scholar
  112. Levenson, A.I. (1982). The growth of investor-owned psychiatric hospitals. American Journal of Psychiatry, 139, 902–907.PubMedGoogle Scholar
  113. Lindsay, C.M. (1982, May). Is there really a crisis in the cost of health care? Colloquium, 3, 1, 2, 8.Google Scholar
  114. Linn, L. (1970). Measuring the effectiveness of mental hospitals. Hospital and Community Psychiatry, 21, 17–22.Google Scholar
  115. Liston, E., & Yager, J. (1982). Assessment of clinical skills in psychiatry. In Teaching psychiatry and behavioral science. New York: Grune & Stratton.Google Scholar
  116. LoGerfo, J.P., & Brook, R.H. (1979). Evaluation of health services and quality of care. In S.J. Williams & P.R. Torrens (Eds.), Introduction to health services. New York: Wiley.Google Scholar
  117. London, P., & Kierman, G.L. (1982). Evaluating psychotherapy. American Journal of Psychiatry, 139, 709–717.PubMedGoogle Scholar
  118. Long, D.A. (1984). Prospective quality assurance. Quality Review Bulletin, 10(5), 143–145.Google Scholar
  119. Looney, J.G., Claman, L., Moir, R., Costello, A.J., Henderson, P.B., & Steffek, J.C. (1984). Data systems in child psychiatry. Journal of the American Academy of Child Psychiatry, 23, 99–104.PubMedCrossRefGoogle Scholar
  120. Luke, R.D., & Boss, R. (1981). Barriers limiting the implementation of quality assurance programs. Health Services Research, 16, 305–314.PubMedGoogle Scholar
  121. Luke, R.D., & Modrow, R. (1982). Professionalism, accountability, and peer review. Health Services Research, 17, 113–123.PubMedGoogle Scholar
  122. Luke, R.D., Kreuger, J.C., & Modrow, R.E. (Eds.). (1983). Organization and change in health care quality assurance. Rockville, MD: Aspen.Google Scholar
  123. Lundberg, G.D. (1983). Rationing human life. Journal of the American Medical Association, 249, 2208–2219.CrossRefGoogle Scholar
  124. Mariner, W.K. (1984, December). Diagnosis related groups: Evading social responsibility? Law Medicine and Health Care, pp. 243–244.Google Scholar
  125. Mattson, M.A. (1984). Quality assurance: A literature review of a changing field. Hospital and Community Psychiatry, 35, 605–616.PubMedGoogle Scholar
  126. McAuliff, W.E. (1979). Measuring the quality of medical care: Process versus outcome. Milbank Memorial Fund Quarterly-Health and Society, 57, 118–131.CrossRefGoogle Scholar
  127. McGuire, T.G., & Montgomery, J.T. (1982). Mandated mental health benefits in private health insurance. Journal of Health Politics, Policy and the Law, 7, 380–406.CrossRefGoogle Scholar
  128. Mechanic, D. (1985). Cost containment and the quality of medical care: Rationing stategies in an era of constrained resources. Milbank Memorial Fund Quarterly-Health and Society, 63, 453–475.PubMedCrossRefGoogle Scholar
  129. Medical care costs rose twice as fast as other prices. (1983, April 18). American Medical News, p. 4.Google Scholar
  130. Menninger, R.W. (1977). What is quality care? American Journal of Orthopsychiatry, 47, 476–483.PubMedCrossRefGoogle Scholar
  131. Mental health benefits: Shrinking reimbursement. (1981, November 9). Washington Report on Medicine and Health, pp. 1–4.Google Scholar
  132. Merwin, M.R., & Ochberg, F.M. (1983). The long voyage: Policies for progress in mental health. Health Affairs, 2, 96–127.PubMedCrossRefGoogle Scholar
  133. Mezzich, J.E., & Sharfstein, S.S. (1985). Severity of illness and diagnostic formulation: Classifying patients for prospective payment systems. Hospital and Community Psychiatry, 36, 770–772.PubMedGoogle Scholar
  134. Mollica, R.F. (1983). From asylum to community: The threatened disintegration of public psychiatry. New England Journal of Medicine, 308, 367–373.PubMedCrossRefGoogle Scholar
  135. Moore, S.H., Martin, D.P., & Richardson W.C. (1983). Does the primary care gatekeeper control the costs of health care? New England Journal of Medicine, 309, 1400–1404.PubMedCrossRefGoogle Scholar
  136. More, M.D.’s support proposals to control costs. (1984, January 20). American Medical News, p. 13.Google Scholar
  137. Morrison, B.J., Rehr, H., Rosenberg, G., & Davis, S. (1982). Consumer opinion surveys. Quality Review Bulletin, 8(2), 19–24.PubMedGoogle Scholar
  138. Munich, R.L., Carsky, M., & Appelbaum, A. (1985). The role and structure of long-term hospitalization: Chronic schizophrenia. Psychiatric Hospital, 16, 161–169.Google Scholar
  139. Name of new game: Allocation of resources. (1983, January 7). American Medical News, pp. 1, 7, 8.Google Scholar
  140. National Association of Private Psychiatric Hospitals. (1985). A proposal on prospective reimbursement for psychiatric hospitals. Washington, DC: Author.Google Scholar
  141. National Center for Health Sciences Research. (1979). Computer applications in health care(DHEW Publication No PH5 79-3251). Washington, DC: Author.Google Scholar
  142. National Center for Health Services Research. (1983). Economic incentive and physician practice: An examination of Medicare participation decisions and physician-induced demand(Publication No PB-83-208132). Washington, DC:Author.Google Scholar
  143. National utilization standard urged. (1983, July). Hospital Peer Review, p. 96.Google Scholar
  144. Nelson, A.R. (1984, April). Health care and its effect on the economy. Statement of the American Medical Association to the Joint Economic Committee, United States Congress, Washington, D.C.Google Scholar
  145. Nelson, S.H. (1979). Standards affecting mental health care: A review and commentary. American Journal of Psychiatry, 136, 303–307.PubMedGoogle Scholar
  146. New trends in care seen as reimbursements cut. (1983, January 7). American Medical News, pp. 1, 24.Google Scholar
  147. Newble, D.I. (1983). The critical incident technique: A new approach to the assessment of clinical performance. Medical Education, 17, 401–403.PubMedCrossRefGoogle Scholar
  148. Newman, F. (1982). Outcome evaluation and quality assurance in mental health. Quality Review Bulletin, 8(4), 27–31.PubMedGoogle Scholar
  149. Nutting, P.A., Shorr, G.I., & Kurkhalter, B. (1981). Assessing the performance of medical care systems: A method and its application. Medical Care, 19, 281–296.PubMedCrossRefGoogle Scholar
  150. Oulton, R. (1981). Use of incident report data in a system-wide quality assurance/risk management program. Quality Review Bulletin, 7(6), 2–7.PubMedGoogle Scholar
  151. Pattison, R.V., & Katz, H.M. (1983). Investor-owned and not-for-profit hospitals. New England Journal of Medicine, 309, 347–353.PubMedCrossRefGoogle Scholar
  152. Payne, B.C., Lyons, T.G., & Neuhaus, E. (1984). Relationships of physician characteristics to performance quality and improvement. Health Services Research, 19, 307–332.PubMedGoogle Scholar
  153. Perlman, B.B., Schwartz, A.H., Paris, M., Thronton, J.C., Smith H., & Weber, R. (1982). Psychiatric records: Variations based on discipline and patient characteristics, with implications for quality of care. American Journal of Psychiatry, 139, 1154–1157.PubMedGoogle Scholar
  154. Platt, R. (1983). Cost containment—Another view. New England Journal of Medicine, 309, 726–730.PubMedCrossRefGoogle Scholar
  155. Pollard, M.R. (1983). Competition or regulation. Journal of the American Medical Association, 249, 1860–1863.PubMedCrossRefGoogle Scholar
  156. President’s Commission on Mental Health. (1978). Report to the President. Washington, DC: U.S. Government Printing Office.Google Scholar
  157. Prospective payment presents challenges for UR, QA. (1983, October). Hospital Peer Review, pp. 57-60.Google Scholar
  158. Public Health Service. (1980). Report to the Secretary: Toward a national plan for the chronically mentally ill. Washington, DC: U.S. Government Printing Office.Google Scholar
  159. Public Health Service. (1981). Better health for our children—A national strategy (DHHS Publication No. 79-55071). Washington, DC: U.S. Government Printing Office.Google Scholar
  160. Rappleye, W.C. (1983, December). System for rational choices. Financier, pp. 19–29.Google Scholar
  161. Reeder, M.P. (1981). The benefits of areawide quality review. Quality Review Bulletin, 7(12), 2–3.PubMedGoogle Scholar
  162. Regier, D.A., Shapiro, S., Kessler, L.G., & Taube, C.A. (1984). Epidemiology and health services resource allocation policy for alcohol, drug abuse and mental disorders. Public Health Reports, 99, 483–492.PubMedGoogle Scholar
  163. Relman, A.S. (1983a, July). The future of medical practice. Health Affairs, pp. 5-19.Google Scholar
  164. Relman, A.S. (1983b). Investor-owned hospitals and health care costs. New England Journal of Medicine, 309, 370–372.PubMedCrossRefGoogle Scholar
  165. Relman, A.S. (1983c, December). Powerful new policy force: The medical industial complex. Financier, pp. 40-44.Google Scholar
  166. Restuccia, J.D., & Holloway, D.C. (1982). Methods of control for hospital quality assurance systems. Health Services Research, 17, 182–197.Google Scholar
  167. Revolutionary computer system helps assure quality. (1984, May). Hospital Peer Review, pp. 57-61.Google Scholar
  168. Ricardo-Campbell, R. (1982). The economics and politics of health. Chapel Hill, NC: University of North Carolina Press.Google Scholar
  169. Richman, A., & Barry, A. (1985). More and more is less and less. British Journal of Psychiatry, 146, 164–168.PubMedCrossRefGoogle Scholar
  170. Rodriguez, A.R. (1983a, October). National standards of review. Paper presented at the meeting of the American College of Utilization Review Physicians, Denver.Google Scholar
  171. Rodriguez, A.R. (1983b). Psychological and psychiatric peer review at CHAMPUS. American Psychologist, 38, 941–947.PubMedCrossRefGoogle Scholar
  172. Rodriguez, A.R. (1985). Current and future directions in reimbursement for psychiatric services. General Hospital Psychiatry, 7, 341–348.PubMedCrossRefGoogle Scholar
  173. Rodriguez, A.R., & Maher, J.J. (1986). Psychiatric case management at CIBA-GEIGY. Business and Health, 3(3), 14–17.PubMedGoogle Scholar
  174. Rubin, J. (1980). A survey of mental health policy options. Journal of Health Politics, Policy and the Law, 5, 210–232.Google Scholar
  175. Rubin, J. (1982). Cost measurement and cost data in mental health setting. Hospital and Community Psychiatry, 33, 750–754.PubMedGoogle Scholar
  176. Rutstein, D.D., Berenberg, W., Chalmers, T.C., Child, C.G., Fishman, A.P., & Perrin, E.B. (1976). Measuring the quality of medical care. New England Journal of Medicine, 294, 582–588.PubMedCrossRefGoogle Scholar
  177. Rzaha, C.B. (1983). Quality assurance in long term care. Quality Review Bulletin, 9(8), 229–232.Google Scholar
  178. Sammons, J.H. (1983, December). Doctors’ active role in shaping tough policy choices. Financier, pp. 46-50.Google Scholar
  179. Sanazaro, P. J. (1980). Quality assessment and quality assurance in medical care. Annual Review of Public Health, 1, 31–48.CrossRefGoogle Scholar
  180. Sanazaro, P.J., & Williamson J.W. (1970). Physician performance and its effects on patients. Medical Care, 8, 299–308.PubMedCrossRefGoogle Scholar
  181. Sandrick, K.M. (1982). Private review—Its impact on health care and physicians. Quality Review Bulletin, 8(4), 5–6.PubMedGoogle Scholar
  182. Saxe, L., Cross, T., Siverman, N., Batchelor, W.F., (1986). Children’s mental health: Problems and services—A background paper.(Office of Technology Assessment, OTA-BP-H-33) Washington, DC: U.S. Government Printing Office.Google Scholar
  183. Schacht, T.E., & Strupp, H.H. (1985). Evaluation of psychotherapy. In H.I. Kaplan, & B. J. Sadock (Eds.), Comprehensive textbook of psychiatry (4th ed., Vol. 2). Baltimore: Williams & Wilkins.Google Scholar
  184. Schorr, B. (1983, December 2). Hospitals scramble to track costs as insurers limit reimbursements. Wall Street Journal, p. 2.Google Scholar
  185. Schuchman, H., Nye, S.G., Foster, L.M., & Lanman, R.B. (1980). Confidentiality of health records: A symposium on current issues, opportunities and unfinished business. American Journal of Orthopsychiatry, 50, 639–677.PubMedCrossRefGoogle Scholar
  186. Schulberg, H.C., & Baker, F. (Eds.). (1979). Program evaluation in the health fields (Vol. 2). New York: Human Science Press.Google Scholar
  187. Schulz, R.I., Greenley, J.R., & Peterson R. W. (1983). Management, cost and quality of acute inpatient psychiatric services. Medical Care, 21, 911–928.PubMedCrossRefGoogle Scholar
  188. Schumacher, D.N., Clopton, C.J., & Bertram, D.A. (1982). Measuring hospital case mix. Quality Review Bulletin, 8(4), 20–26.PubMedGoogle Scholar
  189. Scott, W.R. (1982). Managing professional work: Three models of control for health organizations. Health Services Research, 17, 198–211.Google Scholar
  190. Shadish, W.R., & Bootzin, R.R. (1984). Social integration of psychiatric patients in nursing homes. American Journal of Psychiatry, 141, 1203–1207.PubMedGoogle Scholar
  191. Sharfstein, S.S., & Taube, C.A. (1982). Reductions in insurance for mental disorders: Adverse situation, moral hazard and consumer demand. American Journal of Psychiatry, 139, 1425–1430.PubMedGoogle Scholar
  192. Shaughnessy, P.W., & Kurowski B. (1982). Quality assurance through reimbursement. Health Services Research, 17, 157–182.PubMedGoogle Scholar
  193. Shortell, S.M., & LoGerfo, J.P. (1981). Hospital medical staff organization and quality of care. Medical Care, 19, 1041–1055.PubMedCrossRefGoogle Scholar
  194. Sloan, F.A. (1982). Effects of health insurance on physicians fees. Journal of Human Resources, 17, 533–557.PubMedCrossRefGoogle Scholar
  195. Sloan, F.A. (1983). Rate regulation as a strategy for hospital cost control. Milbank Memorial Fund Quarterly—Health and Society, 61, 195–221.PubMedCrossRefGoogle Scholar
  196. Sloan, F.A., & Schwartz, W.B. (1983). More doctors: What will they cost? Journal of the American Medical Association, 249, 766–769.PubMedCrossRefGoogle Scholar
  197. SMI presents alternative to current UR tools. (1983, April). Hospital Peer Review, pp. 41-43.Google Scholar
  198. Smith, D., & Metzner, C. (1970). Differential perceptions of health care quality in a prepaid group practice. Medical Care, 8, 264–275.PubMedCrossRefGoogle Scholar
  199. Snoke, A.W. (1982). The need for a comprehensive approach to health and welfare. American Journal of Public Health, 72, 1028–1034.PubMedCrossRefGoogle Scholar
  200. Spitzer, R.L., & Endicott, J. (1975). Psychiatric rating scales. In A.M. Freedman, H.I. Kaplan, & B.J. Sadock (Eds.), Comprehensive textbook of psychiatry/II (2nd ed., Vol. 2). Baltimore: Williams & Wilkins.Google Scholar
  201. Spitzer, R.L., Endicott, J., Fleis, J., & Cohen, J. (1970). The psychiatric status schedule: A technique for evaluating psychopathology and impairment in role functioning. Archives of General Psychiatry, 23, 41–55.PubMedCrossRefGoogle Scholar
  202. Spitzer, R.L., Gibbon, M., & Endicott, J. (1973). Global assessment scale. New York: New York State Department of Mental Hygiene.Google Scholar
  203. Stuart, B., & Stockton, R. (1973). Control over the utilization of medical services. Milbank Memorial Fund Quarterly—Health and Society, 51, 341–394.PubMedCrossRefGoogle Scholar
  204. Talbott, J.A. (1984). Psychiatry’s agenda for the 80s. Journal of the American Medical Association, 251, 2250.PubMedCrossRefGoogle Scholar
  205. Tarlov, A.R. (1983). The increasing supply of physicians, the changing structure of the health services system, and the future practice of medicine. New England Journal of Medicine, 308, 1235–1244.PubMedCrossRefGoogle Scholar
  206. Taub, S. (1983, June). Psychiatric malpractice in the 1980’s: A look at some areas of concern. Law Medicine and Health Care, pp. 97-103.Google Scholar
  207. Taube, C.E., & Barrett, S.A. (Eds.). (1985). Mental health, United States 1985 (DHHS Publication No. ADM 85-1378). Washington, DC: U.S. Government Printing Office.Google Scholar
  208. Test program to assess physicians in Maryland, Virginia, Washington, D.C. (1981, May). Hospital Week, p. 3.Google Scholar
  209. Thompson, R.E. (1981). Relating continuing education and quality assurance activities. Quality Review Bulletin, 7(1), 3–6.PubMedGoogle Scholar
  210. Thompson, R.E., & Rodrick, A.G. (1982). Integrating patient concerns into quality assurance activities. Quality Review Bulletin, 8(2), 16–18.PubMedGoogle Scholar
  211. Wagner, D.P., Knaus, W.A., & Draper, E.A. (1983). Statistical validation of a severity of illness measure. American Journal of Public Health, 73, 878–884.PubMedCrossRefGoogle Scholar
  212. Walter, R.S. (1983, February). The hottest new thing in utilization review. Medical Economics, pp. 177, 180-181.Google Scholar
  213. Ware, J.E., Johnston, S.A., Davies-Avery, A., & Brook, R.H. (1979). Conceptualization and measurement of health for adults in the health insurance study: Vol. III. Mental health(R-1987/3-HEW). Santa Monica, CA: Rand Corporation.Google Scholar
  214. Warner, A.M. (1983). Thoughts about the cost of quality assurance. Quality Review Bulletin, 9(2), 39–41.PubMedGoogle Scholar
  215. Weinstein, M.C., & Fineberg, H.V. (1980). Clinical decision analysis. Philadelphia: W.B. Saunders.Google Scholar
  216. Wendorf, B. (1982). Ethical decision-making in quality assurance. Quality Review Bulletin, 8(1), 4–6.PubMedGoogle Scholar
  217. Wennberg, J. (1986). Which rate is right? New England Journal of Medicine, 314, 310–311.PubMedCrossRefGoogle Scholar
  218. Wetherill, H.G. (1915). A plea for higher hospital efficiency and standardization. Surgery, Gynecology, Obstetrics, 20, 705–707.Google Scholar
  219. Wilder, J.F., & Rosenblatt, A. (1977). An assessment of accountability areas by psychiatrists, psychologists and social workers. American Journal of Orthopsychiatry, 47, 336–340.PubMedCrossRefGoogle Scholar
  220. Wilensky, G.R., & Rossiter, L.F. (1983). The relative importance of physician-induced demand in the demand for medical care. Milbank Memorial Fund Quarterly—Health and Society, 61, 252–277.PubMedCrossRefGoogle Scholar
  221. Williams, K.N., & Brook, R.H. (1978). Quality measurment and assurance: A review of the recent literature. Health and Medical Care Services Review, 1, 3–15.Google Scholar
  222. Williamson, J.W., & Associates. (1982a). Teaching quality assurance and cost containment in health care. San Francisco: Jossey-Bass.Google Scholar
  223. Williamson, J.W., Hudson, J.I., & Nevins, M.M. (1982b). Principles of quality assurance and cost containment in health care. San Francisco: Jossey-Bass.Google Scholar
  224. Wolfson, J., & Levin, P.J. (1985). Managing employee health benefits. Homewood, IL: Dow Jones-Irwin.Google Scholar
  225. Wyszewianski, L. (1982). Market-oriented cost containment strategies and quality of care. Milbank Memorial Fund Quarterly—Health and Society, 60, 518–550.PubMedCrossRefGoogle Scholar
  226. Youel, D.B. (1983, February). Patient care, continuing health professions education, and quality assurance. American College of Utilization Review Physicians Newsletter, pp. 1-2.Google Scholar
  227. Ziegenfuss, J.T. (1985). DRGs and hospital impact. New York: McGraw-Hill.Google Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Alex R. Rodriguez
    • 1
  1. 1.Preferred Health Care, Ltd.WiltonUSA

Personalised recommendations