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Joint Commission on Accreditation of Healthcare Organizations: 1995 Accreditation Manual for Hospital Volume I, Standards. Oakbrook Terrace, IL, 1993. Donabedian, 1980, vol 1 1994, Joint Commission Perspectives, 14, 11 Opus II Communications: Medical Staff Briefing, vol 3, 1993. Shapiro, 1993, Containing costs while improving quality of care: The role of profiling and practice guidelines, Annu Rev Public Health, 14, 219, 10.1146/annurev.pu.14.050193.001251 Jencks, 1992, A new approach to quality assurance in Medicare, JAMA, 268, 900, 10.1001/jama.1992.03490070082047 1992, Provider Bulletin, PPS, 92 McGuirk-Porell, 1991, A performance-based quality evaluation system for preferred provider organizations, QRB, 365 Siu, 1988, Use of the hospital in a randomized trial of prepaid care, JAMA, 259, 1343, 10.1001/jama.1988.03720090033030 Feldstein, 1988, The effects of utilization review programs on health care use and expenditures, N Engl J Med, 318, 1310, 10.1056/NEJM198805193182006 Day, 1993, Hastening healthcare’s consumer era: An industry emerges to collect, compare price and quality data, Washington Post, H1 Pennsylvania Health Care Cost Containment Council. A Consumer Guide to Coronary Artery Bypass Graft Surgery. Harrisburg, PA, Nov 1992. O’Leary, 1993, The measurement mandate: Report card day is coming, Jt Comm J Qual Improv, 19, 487 Mazzolini, 1993, Report grades Cleveland hospitals: Businesses hope innovative plan will keep costs down, improve quality, The Plain Dealer, 1A Joint Commission on Accreditation of Healthcare Organizations: 1994 Accreditation Manual for Hospitals, Volume 1, Standards, Oakbrook Terrace, IL. Adineh, 1993, Charting a course toward the electronic medical record at Stanford, Healthcare Informatics, 10, 86 Ball, 1993, Aspects of CPRs (computerized patient record) & organizational redesign, Healthcare Informatics, 10, 28 Gabrieli, 1993, Aspects of a computer-based patient record, Journal of the American Health Information Management Association, 64, 70 Pennsylvania Health Care Cost Containment Council: ACT 89. Harrisburg, PA, 1986. Brewster, 1995, MEDIS-GRPS: A clinically based approach to classifying hospital patients at admission, Inquiry, 12, 377 MediQual Systems, Inc.: MedisGroups Glossary. Westborough, MA, 1992. InterQual, Inc: A Review System with Adult ISD Criteria. Malborough, MA, 1992. Pennsylvania Health Care Cost Containment Council: 1990 Data Release for Southwestern PA. Harrisburg, PA, 1991. Brook, 1989 Siu, 1986, Inappropriate use of hospitals in a randomized trial of health insurance plans, N Engl J Med, 315, 1259, 10.1056/NEJM198611133152005 Brook, 1983, Does free care improve adults’ health?, N Engl J Med, 309, 1426, 10.1056/NEJM198312083092305 Welch, 1994, An analysis of inpatient practice patterns in Florida and Oregon, N Engl J Med, 330, 607, 10.1056/NEJM199403033300906 Cleary, 1991, Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California, JAMA, 266, 73, 10.1001/jama.1991.03470010077034