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Med Decis Making. 2003 Nov-Dec;23(6):518-25.

When is it worth introducing a quality improvement program? A mathematical model.

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Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universität zu Köln, Köln, Germany.


Quality improvement programs must compete with other health care interventions for limited health care resources. The goal of the research presented here was to develop a model that portrays the mathematical relationship between the size of a quality deficit caused by the noncompliance of health professionals and the cost-effectiveness of a quality improvement program. The model allows the determination of the minimum size of a quality deficit for which it is worth introducing a quality improvement program. If a quality improvement program has already been implemented, the model can be used to define the quality threshold beyond which a reduction in quality becomes economically unattractive. An example considering the reduction of underuse in depression treatment demonstrates that an intervention with a favorable cost-effectiveness ratio may become economically unattractive once the costs for the implementation effort are considered.

[Indexed for MEDLINE]

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