The unbearable vagueness of “quality”

Aaron is chugging along in his series on the “quality” of the U.S. health system. Reading the comments so far, I had this reaction:

Part of the challenge here is that “quality” is not and cannot be defined in as precise a degree as “spending.” Perhaps it would be more accurate to view the “quality” series as really addressing the question, “What do we get for what we spend?” Getting more per dollar is, in a narrow sense, a better value. That is not the same thing as saying it implies better health.

Aaron thought this worth mentioning in a post, so I am. I wish we could measure “quality” or “health” as well as spending. But we can’t. So Aaron is doing what most do, which is to examine a host of measures to get a general sense of whether the U.S. health system is performing as well as we might expect or want it to given what we spend.

Yes it is vague and imprecise. Could something better, more accurate, and more convincing be done? If so, let us know what it is. Point to papers and data. If we can do it on a budget of approximately $0, we will!

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