Medicare: A Strategy For Quality Assurance, I: A Recapitulation of the Study and a Definition of Quality of Care

The first of a series of articles on the Institute of Medicine study on a quality review and assurance program for Medicare, this article reviews the findings, conclusions, and recommendations of the IOM study committee and discusses the quality-of-care definition, which became a focal point for the report. A QA system should achieve a balance among important dimensions of "quality of care;" several such dimensions were identified. Turning the definition into practical measurement and intervention approaches and implementing a QA strategy based on it remain significant challenges.