In 1990, the Institute of Medicine (IOM) defined quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.” Quality can impact healthcare costs, the effectiveness of patient care, and the extent to which patients understand and are able to comply with a plan of care.
From the physician perspective, this means providing value-based care with the most up-to-date technology to achieve quality patient outcomes. From the patient point of view, one of the significant measures of quality care, factors include:
- Staying Healthy. Getting help to avoid illness and remain well.
- Getting Better. Getting help to recover from an illness or injury.
- Living with Illness or Disability. Getting help with managing an ongoing, chronic condition or dealing with a disability that affects function.
- Coping with the End of Life. Getting help to deal with a terminal illness.
These categories were developed based on Foundation for Accountability (FACCT) research, which studied the patient side of the IOM framework for quality.
The Centers for Medicare & Medicaid Services (CMS) identifies six goals within its Quality Strategy, which help outline the importance of care quality for its patients:
- Goal 1: Make care safer by reducing harm caused in the delivery of care.
- Goal 2: Strengthen person and family engagement as partners in their care.
- Goal 3: Promote effective communication and coordination of care.
- Goal 4: Promote effective prevention and treatment of chronic disease.
- Goal 5: Work with communities to promote best practices of healthy living.
- Goal 6: Make care affordable.
Care quality contributes not only to the short-term health of the primary care physician’s patients, but also to the provider’s ability to effectively coordinate care for those patients who need to see multiple physicians. The quality of care provided to primary care patients can impact them long-term, as well, strengthening potential social determinants of care quality, reducing costs, and improving outcomes as the care becomes more efficient and more effective.