A Managed Care Pharmacoeconomic Research Model Based on the Managed Care Outcomes Project

Abstract

Many American health care facilities have come to understand that quality controls cost. Clinical practice improvement (CPI) is a methodology that creates a clinical laboratory, built into the everyday practice setting, to find and test the best practices. A CPI study is an analysis of the content and timing of the individual steps of a medical care process to produce better clinical outcomes for the least necessary cost over the continuum of a patient's care. Statistical analyses are used to determine whether and how much a particular step actually improves medical outcomes. Systematic determination of individual medical process steps that improve medical outcomes is the best way to develop demonstrably better care and practice. Combining CPI methodology and a clinical quality monitor creates a dynamic environment in which all patient encounters potentially contribute to improving the process of care. We describe a recent multisite study: the Managed Care Outcomes Project (MCOP). The MCOP study design permits us to compare the effects of various pharmaceutical treatments on resource utilization in actual practice in managed care organizations. The MCOP database is an important resource for developing information required to design systems-based disease management programs. Copyright © 1995 by W.B. Saunders Company