Quality Assurance in Medicine

Experience in the Public Sector

by Kathleen N. Lohr, Robert H. Brook

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This report describes and reflects upon current quality assurance efforts in the health care field. It defines the concepts of quality of care and quality assurance, and recounts the history of the quality assurance movement. It then describes three initiatives in quality assurance sponsored by the federal government: Experimental Medical Care Review Organizations, Professional Standards Review Organizations, and Utilization and Quality Control Peer Review Organizations. The authors conclude that quality assurance is unlikely to grow in prominence or funding, but that the legacy of the federal programs is very positive. Methods for providing quality assurance as well as for evaluating quality assurance organizations showed progress in an environment almost wholly concentrated on controlling the costs of medical care.

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