Until recently, we relied primarily on professional judgmentto ensure that patients received high-quality medical care.Hospitals routinely monitored poor outcomes, such as deathsor infections, to identify ways to improve the quality of care.In rare cases, medical societies reviewed the performance ofphysicians. However, monitoring of and improvement in qualitywere generally left to individual clinicians.
This situation has changed dramatically. We have learned thatpractice patterns and the quality of medical care vary muchmore than many people had realized, our ability to measure thequality of care has advanced considerably, and clinicians areincreasingly interested in . . . [Full Text of this Article]
Structure, Process, and Outcome
Methods of Quality Assessment
Selecting Sources of Data
Successful Examples of Developing Measures of Quality
Congruity of Assessment Measures
Comprehensiveness of Quality-of-Care Measures
Conclusions
Source Information
RAND Santa Monica, CA 90407 Harvard Medical School Boston, MA 02115
Address reprint requests to Dr. Brook at RAND, 1700 Main St., Santa Monica, CA 90407.
References
Related Letters:
Series on the Quality of Health Care
Loftman B. A., Weinberg D., Stewart G. M., Friedman S. A., Greenwald M. S., Marciniak T. A., Golden W. E., Brasher R., Baker R., Lakhani M., Blumenthal D., Brook R. H., McGlynn E. A., Cleary P. D., Berwick D. M.
Extract |
Full Text
N Engl J Med 1997;
336:804-807, Mar 13, 1997.
Correspondence
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