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In September 1998, the Advisory Commission on Consumer Protection and Quality in the Health Care Industry released its final report on how to define, measure, and promote quality of health care. With new organizational structures and reimbursement strategies that may affect quality of care, the health care system has undergone a dramatic transformation. Concerns about potentially negative consequences prompted a movement to assure that quality will not be sacrificed to control costs. This study reviews the academic literature on quality of care in the U.S. and provides an overview of quality of care delivery across diverse settings, conditions, and demographic groups. Quality of care in the U.S. varies among hospitals, cities, and states, some of it outstanding, but much of it not meeting professional standards. A systematic strategy for routine monitoring and reporting on quality is essential to preserve quality and to improve efficiency of high-quality health services.

Originally published in: The Milbank Quarterly, v. 76, no. 4, 1998, pp. 517-563.

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