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Article
November 1997

Patient SatisfactionQuality of Care From the Patients' Perspective

Author Affiliations

From the Departments of Dermatology and Cutaneous Surgery and Epidemiology and Public Health, University of Miami School of Medicine, Miami, Fla (Dr Kirsner), and the Division of General Medicine, West Haven Veterans Administration Hospital, Yale University School of Medicine, West Haven, Conn (Dr Federman).

Arch Dermatol. 1997;133(11):1427-1431. doi:10.1001/archderm.1997.03890470105017
Abstract

The rapidly changing health care delivery system in the United States has led to renewed interest in the quality of medical delivery, which has been in some part due to the rise in the number of patients enrolled in managed care.1 The development of health maintenance organizations (HMOs) promised reduced medical costs and improved quality. Managed care companies have reduced the cost of medical care, mainly by reducing hospital admissions, reducing the length of hospitalization, and requiring preapproval for high-technology procedures.2 How managed care has affected quality is less well documented; at least in some instances, managed care has led to a reduction in quality.3 Who and what defines quality is often a difficult question. The measurement of quality depends on several factors, including who is doing the measuring and what factors they are measuring. For example, if physicians are measuring quality, they are likely to measure

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