Performance Measurement in the Hospital Outpatient Setting. Deficits in Quality of Care

02/01/2008

A variety of studies have documented substantial deficiencies in the quality of care delivered across the United States (Asch et al., 2006; Institute of Medicine [IOM], 2000, 2001, 2005; Schuster et al., 1998; Wenger et al., 2003). In a national examination of the quality of care delivered to adult patients, McGlynn and colleagues found that patients received on average only about 55 percent of recommended care and that adherence to clinically recommended care varied widely across medical conditions (McGlynn et al., 2003). Wenger and colleagues found similar results for vulnerable elders living in community settings, with worse performance for geriatric conditions (Wenger et al., 2003). While there are no similar studies of the quality of care delivered in the hospital outpatient setting, pervasive deficits across the health system suggest similar problems likely exist in this setting, particularly since a large fraction of care delivered in the hospital outpatient setting is ambulatory care for acute and chronic conditions.

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