Boosting performance measure for measure

BMJ 2003; 326 doi: (Published 12 June 2003) Cite this as: BMJ 2003;326:1278

Patients have a critical role in quality measurement and accountability

  1. Daniel Stryer (, acting director,
  2. Carolyn Clancy, director
  1. Center for Quality Improvement and Patient Safety
  2. Agency for Healthcare Research and Quality, US Department of Health and Human Services, 540 Gaither Rd, Rockville, MD 20850, USA

    The American healthcare system contrasts with healthcare systems in all other countries. Far more money is spent on health care in the United States than in any other country. Also, the marketplace rather than regulatory mechanisms is entrusted with promoting innovation and addressing suboptimal performance and inefficiencies since insurance is provided through a mix of public and private sources. Despite the obvious differences between the American and other systems, the challenges of providing safe and effective care transcend borders and financing mechanisms. Ensuring that patients are able to obtain care, whether it be prevention, treatment, or palliation, is a priority for all developed nations, especially as patients are living longer and many are living with chronic illnesses such as coronary artery disease, diabetes, and asthma.

    In an effort to narrow the gap between the best evidence based care possible and actual care, the American healthcare system has invested heavily in measurement and accountability. Over the past decade, numerous reports and data have become available to healthcare decision makers to facilitate quality improvement. In the private sector, the National Committee for Quality Assurance developed the health plan employer data and information set (HEDIS), a set of measures intended to assess the quality of …

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