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Previous Volume 334:741-742 March 14, 1996 Number 11 Next

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By Troyen A. Brennan and Donald M. Berwick. 404 pp. San Francisco, Jossey–Bass, 1996. $36.95. ISBN 0-7879-0149-0.

New Rules describes, and then proposes a solution to, an emerging conundrum in health care: changes in financial incentives and organizational structures are producing new threats to health care quality, yet existing public and private quality-assurance measures are rapidly becoming obsolete and cannot be relied on in any case. Moreover, these diverse state and federal, quasi-public, and private measures are not only ineffectual, cumbersome, and expensive to comply with but are also actually inhibiting the development of more accountable delivery-system arrangements and restricting the application of modern, scientific approaches to quality assurance in health care. As the authors state, . . . [Full Text of this Article]

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