From the Department of Health Policy and Management, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md.
Much of quality assessment is based on approaches that have been around
for the better part of the 20th century. Even the focus on outcomes dates
back more than 80 years to the exhortations of Ernest Codman.1
The inclusion of patient opinion is not new either; consumerism dates back
almost half a century and the literature on consumer attitudes and satisfaction
has a long history.2 The President's Advisory
Commission on Consumer Protection and Quality in the Health Care Industry
spent more than a year discussing the challenges. Its report made more than
50 recommendations to "advance the purposes of continuously reducing the impact
and burden of illness, injury, and disability and to improve the health and
functioning of the people of the United States."3
These recommendations focused primarily on using the results of research to
improve patient care, as well as building an "ongoing research agenda and
capacity for achievement."
Starfield B. Quality-of-Care ResearchInternal Elegance and External Relevance. JAMA. 1998;280(11):1006-1008. doi:10.1001/jama.280.11.1006