Evaluation of the Quality of Medical Care

ALMOST every thoughtful discussion of medical care includes some mention of its quality. Although this interest is widespread more serious attempts have been made to define and measure quality in the United States than elsewhere in the world. This may be because doctors in America take responsibility for patients under more varied circumstances than doctors elsewhere. For example, nonspecialists in the United States do about half the surgery, deliver most of the babies and are often responsible for the care of critically ill patients.1 In European medical practice, by contrast, surgery and obstetrics are largely performed by specialists, and critically . . .