Address Quality Issue in Health Care Industry

By Simmons, Henry E. | The Christian Science Monitor, June 3, 1997 | Go to article overview
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Address Quality Issue in Health Care Industry


Simmons, Henry E., The Christian Science Monitor


The health care industry accounts for $1 trillion in yearly expenditures. It represents approximately 14 percent of gross domestic product. No industry of comparable size exists in our economy. Yet it operates without a systemwide framework for defining, measuring, and ensuring quality. In what other industry would that be tolerated by the American public?

Take the airline industry. After the TWA and ValuJet crashes last year, the government swung into action: The FAA and the FBI launched multimillion-dollar investigations; congressional hearings were called almost immediately; a presidential commission on airline safety headed by the vice president was announced, and sweeping new regulations were unveiled just a few months later; and every sector of the airline industry came under intense scrutiny by Congress and the news media. On average, plane crashes take approximately 700 American lives every year.

Now look at the health care industry, where every year an estimated 180,000 Americans die unnecessarily as a result of errors in medical treatment. An additional 1.3 million are injured, with 1 million of those injuries considered preventable. Despite the alarming prevalence of medical errors in the health care system, no federal investigations are launched, Congress pays little or no attention, and the public is generally unaware. The "dirty little secret" of the world's best health care system is that it is operating in a quality-control vacuum with no universal guidelines for procedures or practices. Our system could be better, safer, and less expensive if we devoted just a fraction of the attention to quality in health care that we do to safety in the airline industry. And the results would be more far-reaching. THE basic quality problems are: overuse, when a health service is provided in circumstances where its risks outweigh its benefits; underuse, the failure to provide a service that provides a benefit and saves money in the long run; and misuse, when a beneficial service is provided poorly, resulting in a preventable complication.

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