Quality of care

Quality of Care

High quality health care is timely, safe, effective, and affordable–the right care for the right person at the right time. High quality care in inpatient and outpatient settings can help protect and improve health and reduce the likelihood of receiving unnecessary or inappropriate care.

Why Is Quality of Care Important to Health?

Evidence-based decisions, performance assessment, and explicit efforts to improve quality, reduce errors, and involve patients in care decisions are often components of high quality health care. Such care requires providers, health systems, and others to work together to improve health outcomes and patient satisfaction while containing costs [1].

Despite efforts towards higher quality care, an estimated 30% of patients did not receive recommended preventive care or treatment in 2009. Poor care coordination within and among facilities can lead to poor health outcomes and readmissions; about 20% of discharged elderly patients return to the hospital within 30 days [1]. Hospital acquired infections killed about 100,000 Americans in 2007, and between 44,000 and 98,000 Americans are estimated to die from medical errors each year [2].

Quality varies widely by state, race, ethnicity, and income [2,3]. Blacks, Hispanics, American Indians and those with low incomes often get lower quality care than non-Hispanic whites and those with high incomes [2]. One study found that women and minorities get lower quality care than their counterparts even when insurance status, income, and condition are accounted for [3]. 

Even with the highest per capita health care spending in the world, the US has shorter lifespans and higher infant mortality rates than other wealthy nations [4]. Several studies estimate that at least 30% of US health expenditures are on practices and procedures that do not improve health [1]. Preventable hospitalizations cost $26 billion in 2009, and in 2008, medical errors cost nearly $20 billion [2].

Adopting and implementing initiatives to improve the quality of health care in all settings can help us all get the care we need when we need it, leading to longer, healthier lives, and healthier, more productive communities.

References

[1] Cosgrove D, Fisher M, Gabow P, et al. A CEO checklist for high-value health care. Washington, DC: Institute of Medicine (IOM); June 2012.
[2] Clancy C, Munier W, Brady J, et al. 2012 National healthcare quality report. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ); 2013.
[3] Aligning Forces for Quality (AF4Q). Improving health care quality: Why you should get involved and how you can make a difference. Princeton: Robert Wood Johnson Foundation (RWJF); 2010.
[4] Robert Wood Johnson Foundation (RWJF). What we’re learning: Clinicians are using data from public reports on their performance to improve care. Princeton: Robert Wood Johnson Foundation (RWJF); 2013. Quality Field Notes Issue Brief No 2. 

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When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Implement multi-component efforts that include coordination of health services by multidisciplinary teams of health care professionals, patient self-management, and patient education
Provide continuous, comprehensive, whole person primary care that uses a coordinated team of medical providers across the health care system

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