US Health Moves And Quality of Care

Quality of care should be dealt with in the same way as issues of cost and access, says a white paper from the US Council of the Institute of Medicine, entitled America's Health in Transition: Protecting and Improving the Quality of Health and Health Care.

The fundamental quality issues which it identifies are: - unnecessary or inappropriate care such as overprescribing antibiotics and excessive use of surgery, which could have harmful side effects and waste money and resources; - underuse of preventative and clinical care due to no insurance cover, managed care arrangements or geographical, cultural or other barriers; and - shortcomings in technical and interpersonal aspects of care. IoM president and council chairman Kenneth Shine said these issues are not considered adequately in several reform plans before Congress, and that new and enhanced measurement tools to assess the quality of care will be needed as the nation's concerns about quality change and its ability to gather and use data evolves.

The Council urges health plans and provider groups to act on their own to measure and improve their performance and patient outcomes so that intrusive programs to micromanage care from the outside can be avoided. But external monitoring will be needed to ensure the integrity of quality management procedures and information, and to assess the population's health. More must be learned about the appropriate contents of "report cards" and how consumers would use this information to make safe choices, it adds.