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History of Health Assessment Essay

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The provision of quality healthcare services to the people is a crucial responsibility for every government. The United States government has for a long time been striving to ensure that the people access high-quality and affordable healthcare services (Jarvis, 2008). Some of the factors that are used for assessing the quality of health services include patient satisfaction, outcomes of diagnostic and therapeutic processes, as well as society’s general sense of satisfaction. The challenge experienced by successive governments is to maintain high-quality health while on the other hand decreasing the costs. Current efforts focus on reforming the health sector with a particular interest in maintaining cost without compromising the quality of healthcare (Luce, Bindman, & Lee, 2004). The essay discusses the history of health assessment and the continuing efforts to improve healthcare.

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During the beginning of the 19th century, medicine in the United States was not well organized and provided poor quality care. Medical education was controlled by individual proprietors and profit-making institutions. Both individual and organizational efforts were made to correct this problem. In 1847, the American Medical Association (AMA) facilitated research and by 1910, findings of investigations into the deplorable state of the medical institutions and various hospitals were released (Wilson & Giddens, 2004). In 1917, the basic standards of the Hospital Standardization Program were developed by the American College of Surgeons. These standards targeted healthcare provision in hospitals.

After the adoption of the minimum standards, there was a need to ensure that all hospitals were accredited after meeting the required standards of operation. Additional requirements were outlined to guide in ensuring that all health institutions met the highest standards (Luce et al., 2004). By 1952, there was a coalition of various health associations that joined the American College of Surgeons to form the Joint Commission on Accreditation of Hospitals. They all aimed at ensuring the effective assessment of health services. The then-new commission reviewed their guiding principles and adopted the optimal achievable standards. The American College of Surgeons and Joint Commission checked medical records with an aim of assessing the quality (Malasanos, 2005). These assessment procedures evolved significantly during the 1970s. In 1979, they formulated quality assurance programs that used a variety of new methods like a generic screen where admission trends are tracked and clinical indicators. The Joint Commission has been making amendments to its operations with an aim of enhancing quality assessment programs (Rhoads, 2006). This has been necessitated by the need to provide up-to-date health care services to all patients.

It was in 1988 that further reforms to the health sector were recommended. They targeted groups of practitioners rather than individuals who were perceived as poor performers. This followed the continued expansion of service providers in healthcare like community mental health, ambulatory care, as well as hospices (Luce et al., 2004). In order to monitor this high rate of expansion, the JC changed its name to the Joint Commission on Accreditation of Healthcare Organization. Government regulatory programs also played a major in the assessment and reform of the healthcare sector in the United States since the end of the 1800s.

The dawn of the 21st century has seen a dramatic change in the landscape of American medicine as far as the assessment of healthcare is concerned. The healthcare sector is now under closer scrutiny to regulate the persons’ behavior. The coming up of corporations has created an environment of competition among physicians (Jarvis, 2008). This has helped in regulating the hospital costs and quality of services provided.

Efforts to improve health care should be made with the deliberate intention to check the associated cost without compromising the quality of service provided to the people. The federal government is seeking to make access to healthcare services affordable for all citizens regardless of social class. Future strategies for enhancing this sector include the reduction of unnecessary services, the use of affordable but highly effective healthcare, and fostering integrated healthcare systems. If the field of medicine is not checked in advance, it is headed to a crossroads where it would be difficult to regulate the various operations by practitioners in the field. Therefore, issues of quality and cost must be assessed on a regular basis in order to protect the consumers of healthcare services.


Jarvis, C. (2008). Physical examination and health assessment (5th ed). St. Louis: W.B. Saunders Co.

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Luce, J. M., Bindman, A. B. & Lee, R. P. (2004). A history of healthcare quality assessment and improvement in the United States. West Journal of Medicine, 160 (3); Pp. 263- 268

Malasanos, L. (2005). Understanding health assessment. Michigan Press

Rhoads, J. (2006). Enhanced health assessment and diagnosis. Lippincott Williams & Wilkins

Wilson, F. S. & Giddens, J. F. (2004). A guide for health assessment for nursing theory and practice (3rd ed). Mosby

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