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Letters Quality in a poorer NHS

Gross and net are not the same

BMJ 2009; 339 doi: (Published 09 December 2009) Cite this as: BMJ 2009;339:b5331
  1. Sarah W Fraser, director1
  1. 1Sarah Fraser and Associates, Aylesbury, Buckinghamshire HP18 0AB
  1. sfraser881{at}

    Crump and Adil add to the debate about the dynamics between quality and cost.1 Most of their evidence for reduced cost and improved quality comes from published improvement projects that show the benefits gained. Although useful, most of these evaluations do not include the cost to make the change. Neither do they clarify the return …

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