Process, cost, and clinical quality: the initial oral contraceptive visit.

Objectives: To demonstrate how the analysis of clinical process, cost, and outcomes can identify healthcare improvements that reduce cost without sacrificing quality, using the example of the initial visit associated with oral contraceptive pill use.

Study Design: Cross-sectional study using data collected by HealthMETRICS between 1996 and 2009.

Methods: Using data collected from 106 sites in 24 states, the unintended pregnancy (UIP) rate, effectiveness of patient education, and unit visit cost were calculated.

Clinical process variation: effect on quality and cost of care.

Objective: To identify optimal transferable practice processes for provision of a clinical service by studying the relationships among unit cost, clinical outcome, patient satisfaction, and staff satisfaction observed for a discreet service performed at multiple sites in a well-defined patient population.

Study Design: Cross-sectional study using data collected by HealthMETRICS from 1996 to 2007.

Methods: Data from 165 US clinics in 29 states, totaling 8835 patients and 1583 clinic staff, were reviewed.