Quality of care Effectiveness, efficiency, appropriateness and patient acceptance are elements of quality of care. Such a service is therefore unlikely to become or remain a core medical service. CPGs are based on a systematic review of experience and research, and they help physicians to make decisions about necessary care. CPGs that are well developed and appropriately evaluated may also help to define core health care services. CPGs are also tools for the pursuit of quality, to maximize effective care and to reduce waste and ineffective activity in a given service, resulting in savings.
Clinical research is a key aspect of improvement in quality of care.
Such research focuses on the effectiveness and results of health care services. Procedures that demonstrate better outcomes than others should be included in a core health care package, whereas those that demonstrate inferior outcomes may be limited or excluded in some instances. When applying the concept of core health care services, provision must be made for ongoing evaluation of the quality of current services and appropriate assessment of new ones. These issues are ethical ones because they involve rights, responsibilities and societal values. Whether decisions about resource allocation are made at the macro, meso or micro level, they must be fair.