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February 1980

Why Medical Audits Are in Disfavor

Author Affiliations

Michael Reese Hospital and Medical Center 29th Street and Ellis Avenue Chicago, IL 60616; Baltimore City Hospitals The Johns Hopkins University 4940 Eastern Ave Baltimore, MD 21224

Arch Intern Med. 1980;140(2):168-169. doi:10.1001/archinte.1980.00330140026011

The Professional Standards Review Organization legislation enacted in 1972 (Public Law 92-603) had dual, interrelated objectives2: cost saving by reimbursing only for necessary services and hospital admissions, and assuring quality of care to patients by peer review. The first goal was to be achieved by utilization review, while medical care evaluation (MCE) studies were to satisfy the quality assurance component. In April 1979, the Joint Commission on Hospital Accreditation, while supporting the necessity for effective quality assurance programs, deemphasized the MCE component. The MCE studies are a type of medical audit and for the purposes of this discussion are used interchangeably with process-oriented medical audits. It is the purpose of this editorial to examine why MCE studies, which are commonly performed in accredited hospitals, have failed to substantially affect patient care.

The language of quality assurance breeds confusion, since the vocabulary is technical and the same terms are frequently

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