Historical Perspective on the Health Care System
Era of Cost
Containment
(1965 - 80s)
Era of Assessment & Accountability - (late 80s - present)
“Outcomes” and “effectiveness” (1990’s)
Tradition of Health Technology Assessment - Before the 1970’s (cont.)
Tradition of Health Technology Assessment - the 1970’s (cont.)
Tradition of Health Technology Assessment - the 1970’s (cont)
Tradition of Health Technology Assessment - the 1970’s (cont)
Tradition of Health Technology Assessment - the 1970’s (cont)
Tradition of Health Technology Assessment - the 1970’s (cont)
Tradition of Health Technology Assessment - the 1970’s - Private sector responses
Tradition of Health Technology Assessment - the 1970’s - Private sector responses
Tradition of Health Technology Assessment - the 1970’s - Private sector responses
Tradition of Health Technology Assessment - the 1970’s – Private/public sector responses
Quality of
care
Variation in use issues
Quality of
care
Variation in use issues
Variation in use – a historical perspective
"Congress began to look to..."
Evidence-based guidelines
-
Types of evidence
Evidence-based guidelines
-
Types of evidence
Evidence-based guidelines -
Outcomes research
Dimensions of oral health outcomes
Evidence-based guidelines
-
Outcomes research
Dimensions of oral health outcomes
Evidence-based guidelines
-
Outcomes research
Dimensions of oral health outcomes
Evidence-based guidelines
-
Outcomes research
Dimensions of oral health outcomes
Evidence-based guidelines
-
Outcomes research
Evidence-based guidelines
-
Need for evidence
Evidence-based guidelines
-
Need for evidence
Quality/Hierarchy of
Evidence
(Guide to Clinical Preventive Services, 2nd ed.)
Biased and defective methodology