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The organizations that have been established to pay health care benefits, such as Medicare, Medicaid, and the "Blues," have initiated a number of programs to improve the likelihood that the dollars they manage are spent in a cost-effective way. This led, initially, to the establishment of peer review organizations and the utilization review initiative. A logical sequel has been the establishment of quality assurance programs. Quality assurance activities, accordingly, seek to assure that the health care dollars spent by these third-party payers are, in fact, resulting in quality medical care.
Unfortunately, efforts to assure that expenditures result in quality medical care are frustrated by high costs of case review, the heterogeneity of the case population, and the lack of consensus relative to measurement parameters.
In spite of these shortcomings, quality assurance is here and is probably here to stay. The third-party payers have contractual agreements with health care organizations to
JOHNSON JT. Quality Assurance Indicators of the American Society for Head and Neck Surgery. Arch Otolaryngol Head Neck Surg. 1991;117(8):844. doi:10.1001/archotol.1991.01870200030002
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