The Concept of Quality in Health Care

Most people who receive inpatient rehabs in New York want services that maximize their health potential and meet their health goals. However, the quality of health care varies considerably across individuals and within communities and among different providers. For example, the average length of stay for hospitalized patients may vary by as much as a month, and the waiting times for outpatient services can be longer than expected. Waiting times can vary even within geographic areas, with populations in rural areas tending to experience longer delays.

Health care is a system of organizations and institutions that provide medical, surgical, and preventive services. Health care also includes a variety of other types of services, such as rehabilitation and community services, and the management of public health and safety issues, such as disease control, poisonings, and accidents. The impact of health care on individual life is substantial and varied. In some cases, it is crucial for preserving life and restoring health. In other cases, it has only marginal influence. The impact of health care on society is much greater, since it helps reduce social costs associated with illness and injury, and provides employment opportunities.

The concept of quality is complex, encompassing the technical, clinical, interpersonal, manual, cognitive, organizational, and managerial elements of health care. A fundamental component is professional judgment, which requires that practitioners use current scientific, medical, and technical knowledge to make decisions and perform tasks. In addition, professionals must consider the values and preferences of their patients in the decision making process. This judgment must be based on an accurate assessment of the situation, taking into account the risks and benefits of all available options.

A major challenge is to integrate these diverse elements into a cohesive whole that assures high-quality health care for all. This is a difficult task as nations wrestle with the organization and financing of health care, deal with cost issues, and respond to the demands of an aging population. For example, many systems are shifting to integrated delivery and payment models, resulting in a wide range of settings for delivering health care services. These changes, combined with the pressures of prospective payment systems and other cost-containment strategies, create the potential for fragmentation and incoherence in the quality of health care.

The overall quality of health care is influenced by numerous factors, including the degree to which the system focuses on patient satisfaction and outcomes; its ability to respond to changing conditions, needs, and preferences; the extent to which it promotes informed choice, consumer protection, and health equity; and the quality of professional performance and health service administration. The quality of health care is further influenced by the ability to use information to enhance its effectiveness and efficiency. For this to happen, accountability must go hand-in-hand with the provision of meaningful information to all stakeholders.