![]() ![]() When she went for her first appointment, she was asked to complete a patient history form in the waiting room. When she called for an appointment, she was told that the first available nonurgent appointment was in 2 months she hoped she would not run out of her blood pressure medication in the interim. Martinez delayed calling her new doctor's office for several months. Juggling repairs on their new apartment, finding the best route to work, getting the children's immunization records sent by mail, and making other arrangements to get them into a new school, Ms. Although she knew nothing about the practice she finally found, she assumed it would be adequate. The first two she called were not accepting new patients. After receiving some recommendations from a neighbor and several coworkers, she called several of the offices to sign up. ![]() Once she had joined Cit圜are, she was asked to choose a primary care physician. She had difficulty knowing which plan to select for her family, but she chose Cit圜are because its cost was comparable to that of other options, and it had pediatric as well as adult practices nearby. Martinez, a divorced working mother in her early 50s with two children in junior high school, was new in town and had to choose an insurance plan. Continued funding for this activity should be ensured. Without ongoing tracking of quality to assess the country's progress in meeting the aims set forth in this chapter, interested parties-including patients, health care practitioners, policy makers, educators, and purchasers-cannot identify progress or understand where improvement efforts are most needed. The Secretary of the Department of Health and Human Services should report annually to Congress and the President on the quality of care provided to the American people. Recommendation 3: Congress should continue to authorize and appropriate funds for, and the Department of Health and Human Services should move forward expeditiously with the establishment of, monitoring and tracking processes for use in evaluating the progress of the health system in pursuit of the above-cited aims of safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Section 913(a)(2) of the act states: “Beginning in fiscal year 2003, the Secretary, acting through the Director, shall submit to Congress an annual report on national trends in the quality of health care provided to the American people.” Agency for Healthcare Research and Quality Part A) provides support for the development of a National Quality Report, which is currently ongoing. Title IX of the Public Health Service Act (42 U.S.C. The committee applauds the Administration and Congress for their current efforts to establish a mechanism for tracking the quality of care. Problems in health care quality affect all Americans today, and all can benefit from a rededication to improving quality, regardless of where they receive their care. This opportunity for improvement is not confined to any sector, form of payment, type of organization, or clinical discipline. The committee believes substantial improvements in safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity are achievable throughout the health care sector. Recommendation 2: All health care organizations, professional groups, and private and public purchasers should pursue six major aims specifically, health care should be safe, effective, patient-centered, timely, efficient, and equitable. Health care should be:Įquitable-providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status. To this end, the committee proposes six specific aims for improvement. It is helpful to translate this general statement into a more specific agenda for improvement-a list of performance characteristics that, if addressed and improved, would lead to better achievement of that overarching purpose. Recommendation 1: All health care organizations, professional groups, and private and public purchasers should adopt as their explicit purpose to continually reduce the burden of illness, injury, and disability, and to improve the health and functioning of the people of the United States. As a statement of purpose for the health care system as a whole, the committee endorses and adopts the phrasing of the Advisory Commission on Consumer Protection and Quality in the Health Care Industry (1998). ![]() To cross the divide between today's system and the possibilities of tomorrow, strong leadership and clear direction will be necessary. This will not be an easy task, but the potential benefits are great. As discussed in Chapter 1, the American health care system is in need of major restructuring. ![]()
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