International journal for quality in health care : journal of the International Society for Quality in Health Care
-
Int J Qual Health Care · Oct 1997
The policy implications of using hospital and physician volumes as "indicators" of quality of care in a changing health care environment.
There is growing interest in the quality of health care and in using quality measures to direct patients to hospitals and providers offering high quality, low cost health care. The dilemma is that, while there is an increasing need for quality indicators as a result of a changing health care environment, this changing environment has important implications for the use of some of these measures. Since the 1970s, a growing body of research in the U. ⋯ S. We then discuss policy considerations and cautions in using volumes, along with suggestions for future research. Our purpose is to point out potential problems and clarify confusions about the use of volumes, so that policymakers and practitioners can be sensitive to the potential minefields they are traversing.