Author Affiliation: Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin Hospitals and Clinics, Madison.
There are 2 major approaches to improving quality in health care: restrict care to high-quality centers or develop quality improvement initiatives to improve care across a broader range of institutions. Policies that incentivize the centralization of care are intended to promote safety and effectiveness, but may have unintended consequences due to restricted access. Concern exists about increasing health care disparities, and decreasing efficiency, timeliness, and continuity of care, other important aspects of quality care according to the Institute of Medicine. Significant improvements in safety and effectiveness must be realized to justify the potential compromise in other aspects of quality. However, the effect of such programs remains largely untested.
Greenberg CC. Promoting Quality Surgical CareThe Next Steps. JAMA. 2013;309(8):827-828. doi:10.1001/jama.2013.1503