Comment on de Brantes, Rastogi, and Painter: reducing avoidable complications in patients with chronic diseases: the Prometheus approach.

摘要

Since the Institute of Medicine's publications (1999, 2001) that highlighted major deficiencies in the quality of health care in the United States, extensive efforts have been made to improve patient care. Legislation was passed that requires reporting of compliance with national performance measures (Public Law 109-171, 2006), guidelines were developed by specialty societies to provide clinical direction (Agency for Healthcare Research and Quality 2011) and pay-for-performance programs were underwritten by hospitals and insurers (Lindenauer et al. 2007). There is little evidence to suggest that these initiatives substantially improved the overall quality of patient care. Meanwhile, health care costs continue to spiral out of control, threatening the stability and welfare of our entire economy.