Evaluating quality of patient care. A strategy relating outcome and process assessment

One of the most important questions to be asked of any health care system is the following:Whoneeds to learnwhatto most improve health status of the population receiving care? Previous studies have demonstrated (1) that there is an important relationship between patient care assessment and education that might provide a framework for answering this question1and (2) that systematic application of this approach requires a priority list of health problems to be studied.2 The first study dealt with physician response to apparently unexpected abnormalities in three routine screening tests in which it was found that physicians made no apparent response of any kind to approximately two thirds of the test abnormalities. In solving this problem, it was learned that systematic investigation is needed to identify education objectives that specify the individual who needs to learn, as well as the goals to be achieved in the