Health Care Reform Is on the Way: Do We Want To Compete on Quality?
Authors: Robert H. Brook
Journal: Annals of Internal Medicine (1994)

Editorials1 January 1994Health Care Reform Is on the Way: Do We Want To Compete on Quality?Robert H. Brook, MD, ScDRobert H. Brook, MD, ScDRAND Corporation, Santa Monica, CA 90407-2138.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-1-199401010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Conversations about health care reform, even those involving physicians, usually focus on cost and access: Should there be a single-payer system? How will managed competition save money? Should patients pay a large deductible or have co-insurance? Will dental and mental care be part of the basic benefit plan? It is strange that these conversations ignore how clinical practice should be altered.In this issue of Annals [1], Topol and Califf endorse a fundamental clinical change involving the release of physician-specific information about performance. In particular, do the patients of physician A do better, after controlling for sickness, than those of ...References1. Topol EJ, Califf RM. Scorecard cardiovascular medicine: its impact and future directions. Ann Intern Med. 1994; 120:65-70. Google Scholar2. Brook RH, McGlynn EA. Maintaining quality of care. In: Ginzberg E, ed. Health Services Research: Key to Health Policy. Cambridge: Harvard University Press; 1991:284-314. Google Scholar3. Brook RH. Maintaining hospital quality: the need for international cooperation. JAMA. 1993; 270:985-7. Google Scholar4. Nightingale F. Mortality of the British army at home and abroad and during the Russian war as compared with the mortality of the civil population in England. Reprinted from: Report of the Commission Appointed to Inquire Into the Regulations Affecting the Sanitary State of the Army. London, England: Harrison and Sons; 1858. Google Scholar5. Pennsylvania Health Care Cost Containment Council. 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Coronary artery bypass surgery: the relationship between in-hospital mortality rate and surgical volume after controlling for clinical risk factors. Med Care. 1991; 29:1094-107. Google Scholar Author, Article, and Disclosure InformationAffiliations: RAND Corporation, Santa Monica, CA 90407-2138.Corresponding Author: Robert H. Brook, MD, ScD, RAND, 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScorecard Cardiovascular Medicine: Its Impact and Future Directions Eric J. Topol and Robert M. 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