QUALITY
One definition of health care quality specifies that “the purpose of the healthcare system must be to continuously reduce the impact of illness, injury and disability and to improve the health and functioning of the people of the United States.” Quality is frequently described as having three dimensions: quality of input resources (certification and/or education of providers); quality of the process of services delivery (the use of appropriate procedures for a given condition); and quality of outcome of service use (actual improvement in condition or reduction of harmful effects).
A large body of research documenting serious problems due to poorly developed systems of care has led to an emphasis on quality in healthcare policy. Evidence of quality problems include:
- high rates of avoidable errors resulting in disability or premature death;
- underutilization of services causing needless complications, higher costs and loss productivity for millions of Americans;
- overuse of services, causing unnecessary, costly services that impose risks to patients; and finally,
It is easy to see how systematic efforts to improve quality lead to increases
in costs, at least initially. As costs rise, employers struggle to afford
health insurance for their employees. As these rising health costs eat
into employer profit margins, the benefits drop, co pays are increased
(costs shifted directly to consumers) or workers are laid off. Therefore
as a general rule, as health care costs increase, access to health care
decreases.
1 Evidence-based healthcare
is the conscientious, explicit and judicious use of current best evidence
in making decisions about the care of individual patients. This approach
must balance the best external evidence with the desires of the patient
and the clinical expertise of healthcare providers (AcademyHealth, 2002).
