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President's Advisory Commission Releases
Final Report on Improving Health Care Quality
March 12, 1998
Chip Malin or Richard Sorian
A Presidential Advisory Commission today released its final report entitled "Quality First: Better Health Care for All Americans", recommending steps to provide a "national commitment to improving health care quality."
"Every day, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function," the report says. But "too many patients receive substandard care," it adds. The Commission identifies four areas of health care that require attention:
- Avoidable errors. Too many Americans are injured during the course of their treatment and many of those injuries lead to increased medical expenses and, in some cases, premature death. For example, an estimated 7,000 Americans die each year because of medication errors.
- Underutilization of services. Too many Americans are not receiving needed care despite a rapidly growing base of evidence of what works and what doesn't. For example, an estimated 18,000 Americans die each year because they did not receive the proper medication following a heart attack.
- Overutilization of services. Too many Americans receive health care services that are not supported by medical evidence, thus increasing costs and endangering patients' lives. For example, a major study estimated that one in five hysterectomies performed in the U.S. each year are unnecessary.
- Variation in services. There is tremendous, unexplainable variation in the delivery of health care services. Such variations exist nationally, regionally, and even in small geographic areas. This is strong evidence that research findings are not being adequately translated into practice.
To move the Nation forward in improving the quality of health care, the Commission recommends the creation of two advisory bodies. A public Advisory Council on Health Care Quality would establish national aims for improvement that would target areas most in need of attention, along with a series of objectives for improvement in each area. The Council would track progress toward improving the quality of health care as well as improvements in consumer protection. A private Forum for Health Care Quality Measurement and Reporting would harness the power of private employers, public programs, consumers, health care practitioners, health plans, accreditation bodies, and others to establish a core set of quality measures that would provide the public with clear indications of the quality of care available to them.
The Commission recommends an initial set of aims for improvement as follows:
- Reducing the underlying causes of illness, injury, and disability.
- Expanding research on new treatments and evidence of effectiveness.
- Assuring the appropriate use of health care services.
- Reducing health care errors.
- Increasing patients' participation in their care.
- Addressing oversupply and undersupply of health care resources.
The Commission's final report also includes its recommendations for a Consumer Bill of Rights and Responsibilities in health care. Included in that document are recommendations covering the following:
- The right to information.
- The right to greater choice of providers.
- The right to confidentiality of health records.
- The right to access to emergency services.
- The right to respect and nondiscrimination.
- The right to participate in all treatment decisions.
- The right to appeal decisions by health plans and others to internal and external bodies.
- A set of responsibilities that all consumers should strive to meet.
Free copies of the Commission's report can be downloaded from the Commission's World Wide Web site (www.hcqualitycommission.gov). Printed copies are available by calling, 800/732-8200 or writing to Consumer Bill of Rights, Box 2429, Columbia, MD 21045-1429.
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Last Revised: Friday, June 19, 1998