Quality of Medical Care: Research in Methods of Assessment and Assurance

摘要

The purpose of this project was to develop and test methodologies for (1) reliably documenting the quality of care provided by an individual or within an institution and (2) validly comparing the quality of care provided by several individuals or within several institutions. These methodologies go beyond systems which detect real or potential deficiencies in care but which cannot document the level of quality of care. In this study, the emphasis was on developing methodologies which would be operationally feasible. Thus, a major consideration was that the methods be practical for ongoing use in a large, prepaid group practice medical care program, acceptable to providers of care and not excessively expensive. The experience gained in these studies makes it clear that quality of care assessment is a difficult, time consuming and costly undertaking. The assessment methodologies studied here are not designed only to detect problems in the quality of care, but also to validly and reliably document the level of quality of care and to compare quality of care over time and between components of a health care delivery system.