The U.S. health care system has well-known problems: high costs and high numbers of uninsured. Perhaps less publicized is the system's struggle to deliver high-quality care—that is, care that's likely to improve health and is consistent with current medical science.
Improving care is a long-term, complex challenge. In a series of studies spanning decades, RAND Health has confronted this challenge by helping to establish the scientific basis for defining and measuring quality of care.
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While monetary incentives and behavioral nudges both have their strengths, neither is enough to reliably change clinician behavior and improve quality of care. Organizational culture provides another important lens to understand why clinicians are practicing in a certain way and to put forth more comprehensive, long-term solutions.
Researchers from the RAND Corporation have been awarded a grant to develop a survey to measure the quality of care provided to people with serious illnesses, an issue of increasing importance as the nation's population of frail older individuals grows.
The VA health care system performs similar to or better than non-VA systems on most measures of inpatient and outpatient care quality, although there is high variation in quality across individual VA facilities.
Only 2.3 percent of New York state health care providers are prepared to care for veterans. Training programs, as well as efforts to incentivize providers to screen veterans, could improve provider readiness.