Measuring Quality: Are We Ready To Compare the Quality of Care among Physician Groups?

• Quality of health care
• Quality assirance, health care
• Case mix
• Bias (epidemiology)
• Physician groups

Americans want high-quality health care, but they are not confident that they are getting it. Nor are Americans confident that they have valid information about the quality of their care. The public, health care purchasers, health system managers, and health policymakers are increasingly interested in getting more, and more accurate, information on the quality of care offered by different health care providers. The gap between the data they want and the data they can get may be widening as the public's expectations exceed what the health system can provide.

Information on quality of care has three principal uses: to support accountability, to inform quality improvement efforts, and to guide choice. This editorial focuses on the role of quality measures in guiding choice, although the three uses are entwined at many levels. Forty-two percent of respondents to a consumer survey conducted by the Agency for Healthcare Research and Quality (AHRQ) and the Kaiser Family Foundation stated that high-quality care was their most important concern in choosing a health plan (1). This evidence that consumers and purchasers want information on quality is encouraging to people who still hope that the public will base its purchasing decisions on quality of care rather than simply cost. According to the elusive “business case for quality,” providers who offer superior care will have more patients and higher payments.

Information about quality can improve care at several points of leverage in the health care system. …