• The quality chasm

    Crossing the Quality Chasm is a 2001 National Academies Press report. With a free registration, you can download the entire report at the prior link. The executive summary is available without registration and includes this passage:

    As medical science and technology have advanced at a rapid pace, however, the health care delivery system has floundered in its ability to provide consistently high-quality care to all Americans. Research on the quality of care reveals a health care system that frequently falls short in its ability to translate knowledge into practice, and to apply new technology safely and appropriately. During the last decade alone, more than 70 publications in leading peer-reviewed journals have documented serious quality shortcomings (see Appendix A). The performance of the health care system varies considerably. It may be exemplary, but often is not, and millions of Americans fail to receive effective care. If the health care system cannot consistently deliver today’s science and technology, we may conclude that it is even less prepared to respond to the extraordinary scientific advances that will surely emerge during the first half of the 21st century.

    Appendix A is a treasure trove, summarizing the literature as of 2001 on under-, over-, and mis-use. My only regret is that it is over a decade old. Though I’m certain a lot of relevant work in these areas has been done over the last decade, I am also certain the fundamental problems remain. The quality chasm is still wide.


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