Mechanisms for Assuring Quality of U.S. Medical Care Services

Past, Present, and Future

by Robert H. Brook, Allyson Ross Davies

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Reviews public- and private-sector programs for assessing and assuring the quality of medical care services, and analyzes their potential effectiveness. In particular, the report examines Professional Standards Review Organizations, the Performance Evaluation Procedures (PEP) used by the Joint Commission on Accreditation of Hospitals, the programs devised by prepaid group practice systems established under the aegis of the Health Maintenance Organization Act of 1973, and the legislative initiatives prompted by the malpractice crisis. Although the report finds numerous deficiencies in current programs and identifies several areas needing further research, it concludes that present-day assessment methods are able to detect deficiencies and should not be delayed for further improvements, the greatest hazards being inaction and the failure to use available results to improve medical care.

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