Date of Conferral
1994
Date of Award
1994
Degree
Ph.D.
Advisor
Robert E. Hoye
Abstract
Health care services in the United States are regulated and monitored by federal and state agencies in order to protect the American public. The primary function of these regulating agencies is to assure that any medical procedure or service meets or exceeds the established minimum standards of care. The purpose of this study is to evaluate one aspect of medical care along with its corresponding quality control system.
In the area of eye surgery and postoperative eye care, this investigator encountered several clinical situations in which the quality of medical care has been compromised, increasing the patient's risk of postoperative complications. This study was designed to evaluate how effective the current quality control mechanisms were in recognizing and dealing with a possible breech in the medical quality of care in the postoperative co-management of eye surgery patients in the State of Arizona. General Systems Theory was used as the theoretical base for the study.
The case-study methodology was deemed most appropriate for evaluating the topic of eye surgery co-management. Statistical verification was accomplished by analyzing the standardized data from the case-study checklist.
The results of the study demonstrate that the medical quality control system in Arizona is not enforcing the established minimum standards of quality for eye surgery co-management.
The primary cause of the regulatory agencies suboptimal performance is that the regulatory mechanism is not functioning as a true system. The current disjointed approach to medical quality in Arizona has resulted in (1) inefficient and ineffective mechanisms which enforce minimum standards of care, (2) more than one standard of care for the same medical service, (3) Medicare reimbursement for medical services by unlicensed health care providers, and (4) substandard medical care causing actual harm and increased risk to the patient.
The recommendations offered to rectify the problems identified by this study are based upon applied systems theory. The American health care system seems destined to undergo changes. The recommendations of this study are attempting to mold one aspect of the current methods of providing health care into a true "system of health care."
