As health care costs continue to rise, budgets continue to fall, and health consumers gain greater access to reliable information on disease conditions and interventions, there is an increased need to determine what is appropriate health management to ensure quality and responsible healthcare. Advances in technology have increased the number and types of surgical/medical interventions available to health clients. Are inappropriate interventions offered on a regular basis? Is the prescribed intervention the most appropriate? This paper introduces the topic of appropriateness in evidenced-based healthcare and discusses how appropriateness can be assessed.
What is appropriateness?
Appropriateness is defined as suitable or fitting for a particular purpose, person or occasion (Webster, 1989). Appropriateness in healthcare is determined when the client 's expected health benefits exceed the expected health risks by a substantial margin, exclusive of cost (RAND, 2001) or a balance between doing good against doing harm (Muir Gray, 1997). According to Muir Gray (1997, p.147), "a study of appropriateness is designed to reveal whether the right patient is given the right treatment at the right time by the right professional in the right place". It is important to note that appropriateness is a subjective measure of outcomes of healthcare. Quality of care outcomes refers to correctness and appropriateness and is demonstrated by the decisions concerning the need for medical and surgical intervention. Evidence of appropriateness in healthcare is needed to improve health outcomes, balance costs, provide guidance to physicians and meet the need of the new informed health consumer.
Appropriateness is unlike effectiveness. Effectiveness refers to the degree in which an intervention achieves the objectives set (Muir Gray, 1997). One criterion of appropriateness is that of necessity. RAND Corporation has defined necessary as an intervention that
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