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Advancing The Quality of Health Care A Policy Statement (1974) / Chapter Skim
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3 The Future of Quality Assurance
Pages 43-46

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From page 43...
... Anticipating the Unexpected High expectations for quality assurance are not necessarily bolstered by the record of other recent social programs. The results of most social programs have been less than expected by their proponents, and in some instances have run counter to the intended social direction.
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From page 44...
... Through the promulgation of national standards for medical care, providers in rural or urban areas that lack adequate medical care resources may face difficulties in achieving compliance with quality assurance standards. One result may be an exacerbation of the geographic maldistribution of physicians as those in underserved areas are given further incentive to leave.
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From page 45...
... One of the fears of the proponents of the HMO is that the imposition of quality assurance standards designed to detect and deter overutilization will unnecessarily burden the HMO, where overutilization is generally not a problem, although underutilization may be. Hence, unless quality assurance programs can be designed to take into consideration the twin problems of over- and underutilization, it is possible that the HMO version of the delivery of health care services may be placed at a disadvantage by quality assurance programs that "look for the wrong thing." What Can We Hope For?
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From page 46...
... Reduction in the cost of providing the current range of health care services may be achievable if the methods employed in quality assurance are successful in winnowing effective-care from ineffective care with a resultant diminution in the provision of those services for which little or no evidence is available as to their efficacy. The resources we save by supporting only effective care could then be redirected to the amelioration of other conditions that have demonstrable impact on health status, such as poor housing, air pollution, noise, and other social and environmental influences.
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