Quality Assessment and Improvement Program
In the United States, a large gap exists between the health care that people should receive and the care they do receive. Originating in the 1960s, RAND Health has conducted extensive research designed to measure, assess, and improve health care quality and to provide reliable information on quality to consumers selecting care providers or health plans, providers seeking to offer the highest quality care, and purchasers choosing the best health plans for their employees.
For many years, RAND Health has been at the forefront of research on health and health care. A recent reorganization was designed to further develop and intensify RAND's research in key areas. RAND Health is now organized around three major programs— Economics, Finance, and Organization; Health Promotion and Disease Prevention; and Quality Assessment and Quality Improvement—and four strategic initiatives: COMPARE, Global Health, Military Health, and Public Health Systems and Preparedness.
The RAND Health Quality Assessment and Quality Improvement program addresses issues related to developing measures of health system performance across multiple dimensions; evaluating the performance of the health system for different population subgroups, facilities, systems, and health professionals; developing and evaluating the effects of interventions to improve the delivery of health care services; and systematically summarizing findings in the scientific literature.
RAND Health designs tools to assess health care quality and the effect of interventions aimed at quality improvement. Tools have been developed to measure all types of health care (screening, diagnosis, treatment, and management), at every stage of life (from prenatal to the end of life), delivered in a variety of settings (including inpatient facilities, ambulatory care clinics, and nursing homes). Many of the groups targeted (such as racial and ethnic minorities, HIV-infected persons, vulnerable elders, and the homeless) have special health care needs. The knowledge that forms the basis of these measuring tools comes from a variety of sources, including systematic reviews of the evidence and expert opinion. Finally, RAND Health's assessments of health care quality consider appropriateness, e.g., barriers that limit access to needed care as well as the provision of unnecessary care.