Such strategies include audit methods and critical path methods. Research suggests audits improve the care of patients with asthma and those with congestive heart failure, as well as the process of consultation with chest physicians and the use of endoscopy. There are initial reports that the technique can decrease length of stay for some procedures such as joint replacement surgery. Back to top Use of Practice Guidelines Rising costs, technology, and increased availability of care through both federal and private insurance have resulted in escalating health care expenditures. These concerns, which relate closely to concerns about quality of care, have spurred stakeholder organizations including professional societies, ad hoc committees, and managed care organizations to develop practice guidelines in an attempt to control cost and to limit inappropriate practice variations and improve care by developing guidelines for many common clinical conditions.
Practice guidelines are integral to managed care and to cost containment in general.
While some guidelines appear to be driven by financial concerns, others focus more noticeably on quality as well as efficiency. Research has demonstrated that effective collaborative management of depression can be developed through guidelines and that guidelines may lead to enhanced care of patients with back pain. Guidelines have also been developed in managed care systems for chest pain, congestive heart failure, and influenza vaccination. Despite these successes, the evidence that practice guidelines positively affect patient care remains sparse. For some, guidelines are viewed as difficult to achieve goals of care.