Abstract
This paper reviews the quality assessment literature, presents a study which compares five different methods of assessing quality of care, and proposes policy recommendations. Results are: (1) Most quality assessment issues are a century old. (2) The results of assessment of quality of care are dependent on the method used; therefore, more methodologic research is needed. (3) The use of lists of criteria, concerning what a physician does, to assess quality of care could result in decreased efficiency in the health system by requiring the performance of ineffective procedures. (4) It is not certain that examination of the level of care rendered will increase the health level of the population; therefore, any national program which assesses quality of care must be prospectively evaluated. (5) A quality assessment system must be concerned with both the population who received services at the institution, and the population who did not but for whom the institution is responsible.
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Public Law 92-603, 92nd Congress of the United States of America, H.R. 1, October 30, 1972. Washington, D.C., U.S. Government Printing Office, pp. 101–114.
Brook, R. H., and Appel, F. A., “Quality of Care Assessment: Choosing a Method for Peer Review.” N. Engl. J. Med. 288, 1323–1329 (1973).
Nightingale, F., “Mortality of the British Army at Home and Abroad and During the Russian War as Compared with the Mortality of the Civil Population in England.” Reprinted from Report of the Commission Appointed to Inquire into the Regulations Affecting the Sanitary State of the Army, London, Harrison and Sons, 1858.
Nightingale, F., Proposal for Improved Statistics of Surgical Operations, London, Savill and Edwards, 1863.
Nightingale, F., Hospital Statistics and Hospital Plans, London, England, Emily and Faithfull, 1862.
Groves, E. W., “A Plea for a Uniform Registration of Operation Results.” Brit. Med. J. 2, 1008–1009 (1908).
Codman, E. A., “The Product of a Hospital.” Surg. Gyn. Obst., pp. 4913–494, April, 1914.
Flexner, A., Medical Education in the United States and Canada, A report to the Carnegie Foundation for the Advancement of Teaching. Bulletin No. 4, Boston, D.B. Updike, The Merrymount Press, 1910.
Mather, N. G., Pearson, N. G., Reed, K. L. Q., et al., “Acute Myocardial Infarction: Home and Hospital Treatment.” Br. Med. J. 3, 334–338 (1971).
University Group Diabetes Program, “A Study of the Effects of Hypoglycemic Agents on Vascular Complications in Patients with Adult Onset Diabetes.” J. Amer. Med. Ass. 19, Suppl. 2 (1970).
Chant, A. D. B., Jones, H. O., and Weddell, J. M., “Varicose Veins a Comparison of Surgery and Injection/Compression Sclerotherapy.” Lancet ii, 1188–1191 (1972).
Piachaud, D., and Weddell, J. M., “Cost of Treating Varicose Veins.” Lancet ii, 1191–1192 (1972).
Walton, J., “Discipline, Methods and Community Power: A Note on the Sociology of Knowledge.” Amer. Sociol. Rev. 31, 684–689 (1966).
Galbraith, J. K., Economics, Peace, and Laughter, New York, Signet Classics, 1972, pp. 17–18.
Brook, R. H., Quality of Care Assessment: Comparison of Five Methods of Peer Review, Washington, D.C., U.S. Government Printing Office, 1973 (available from Office of Scientific and Technical Information, National Center for Health Services Research and Development, 5600 Fishers Lane, Rockville, Maryland, 20852).
Uniform Hospital Abstract: Minimum Basic Data Set. National Center for Health Statistics, Rockville, Maryland, 20852, 1972, DHEW Pub. No. HSM 73-1451.
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From the Carnegie-Commonwealth Clinical Scholar Program of the Johns Hopkins University.
Supported in part by grants 5R01HS00110 and 5T01HS00112 from the National Center for Health Services Research and Development and by the Carnegie Corporation and Commonwealth Fund. Dr. Brook was a Carnegie-Commonwealth Clinical Scholar and is now a Commissioned Officer in the U.S. Public Health Service stationed at the National Center for Health Services Research and Development. This paper does not represent the official position of this agency.
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Brook, R.H. Quality of care assessment: policy relevant issues. Policy Sci 5, 317–341 (1974). https://doi.org/10.1007/BF00144289
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DOI: https://doi.org/10.1007/BF00144289