Linda T. Kohn, Janet M. Corrigan and Molla S. Donaldson, editors. Under-use of services is an ongoing challenge. For example, one study found that 30 percent of women age 52 to 69 in surveyed managed care plans had not received a mammogram in the previous two years. On the other hand, some services are used unnecessarily. One study indicated that half of all patients diagnosed with a cold and two-thirds of the patients diagnosed with acute bronchitis received antibiotics which offer little or no benefit for these conditions.
Screening tests are sometimes misread.
One study found that anywhere from 10 to 30 percent of Pap smear test results were incorrectly classified as normal. Finally, improving health care quality must involve consumers and purchasers of health care who are knowledgeable about quality choices. Yet when considering and selecting their health care options, the majority of Americans do not use quality-related information comparing the quality of health care plans, doctors, or hospitals to make their choices. With respect to the quality of human services, the Department has been engaged in the development of a research strategy to better understand the transformations in human services programs. This strategy identifies the requisite knowledge base, data, performance measures, and program evaluations and research needs for national leadership.