Advancing The Quality of Health Care A Policy Statement (1974) / Chapter Skim
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1 Introduction and Summary
1 Introduction and Summary
Pages 1-6
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From page 1... ...
Expectations for PSROs, however, must be rea~istic if major disappointments are to be avoided and the future development of PSROs as rigid and oppressive regulatory mechanisms is to be prevented. The long-range importance of quality assurance in health care and the immediacy of the problems attending development of PSROs prompted the Institute of Medicine to appoint a committee to examine the "policy issues involved in the establishment of professional standards review organizations or other publicly sanctioned mechanisms for the review of professional standards for medical care." This committee has concluded that the most important needs are for appropriately limited immediate expectations of PSROs and for the establishment of a set of principles to guide their development and assist in the future evaluation of any quality assurance mechanisms.
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The committee believes strongly that the goal of quality assurance can only be achieved by relating assessments of quality to the measurement of results, recognizing that methods of measuring outcomes are not now well advanced, and that many 'factors other than health care affect health status. Present methods of quality measurement, Phi be rudimentary, are a us e fuZ beginning.
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Quality assurance pi ZZ tees t work as a positive concept. The committee strongly believes that provider performance will be changed for the better by education and fis Cal incentives- based on feedback of quad ity assurance data, and not so much by primary reliance on sanctions and punishment of providers .
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. The committee reached its conclusions in a context of assumptions and observations about the future of the nation's health care system and the appropriate role of a quality assurance program: -- the United States will continue to have a variety of arrangements for the provision of health care; -- social pressures will increase for equitable, effective, and efficient health care for the entire population; -- demands will grow for broader public participation in all aspects of health, including the financing, organization, distribution and evaluation of services; -- the health professions increasingly will be required to account to consumers, fiscal intermediaries, and governments for prudent use of resources.
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The new emphasis on rationality of practitioner decis ions accompanies a growing perception of the scientific aspect of health care. Better 5 Pals .
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But the emergence of more sys tematic approaches to the regulation of quality can enlarge the consumer influence; consumers can be informed of the relative effectiveness of various heal th providers and make their choices accordingly . The committee regards PS ROs as having the potential to encourage the trend in quality assurance toward a concern for general improvements in practitioner decis ion making and a more informed role for consumer choice.
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