THE NEED for rationalization and improvement of medical and health care services grows more pressing with time. The costs of health care in America will exceed 13% of the gross domestic product in 2002.1 Further, the specter of rapid growth far exceeding the general inflation rate has returned, raising the costs of health insurance to employers, other payers, and employees and patients alike.1 Even with the economic growth of the last decade, the number of uninsured Americans remained at more than 40 million before the most recent economic downturn.2 The costs of prescription drugs have caused many Americans to consciously reduce their prescribed doses.3 At the same time, according to the Institute of Medicine and RAND, 4,5 heightened attention to the quality of care that is being delivered has demonstrated systematic and widespread deficiencies. This confluence of events will engender pressure to substantially change the nature of the health care delivery system to provide better care at a more affordable cost. Paradoxically, it is this crisis situation that will create the impetus to actually implement reforms to enhance the role of quality of care in pricing and purchasing decisions.6
Lee PP. Measuring Outcomes in Chronic Diseases: Ready for Prime Time? Arch Ophthalmol. 2003;121(5):712–714. doi:10.1001/archopht.121.5.712
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