Managing the delivery of health care: care-plans/managed care/practice guidelines.

Concerns about increasing costs of health care combined with an increasing appreciation of the variability in health care delivery practices has led to the development of strategies to better standardise health care delivery. Care-plans and practice algorithms define road maps of care and decision algorithms for individual patient conditions. When incorporated into routine clinical practice and coupled with the recording of the outcomes of care, they permit an improved understanding of how to provide more cost-effective health care. Routine integration into information systems should help to establish a continuous quality improvement model for health care delivery. Substantial problems exist, however, in the development of care-plans and integrating them into information systems and routine clinical practice.