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Pediatr Clin North Am. 2009 Aug;56(4):731-43. doi: 10.1016/j.pcl.2009.05.013.

Making the case to improve quality and reduce costs in pediatric health care.

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National Outcomes Center and Children's Hospital of Wisconsin, 9000 W. Wisconsin Avenue, MS-950, Milwaukee, WI 53226, USA.


This article makes a case for the urgent need to improve health care quality and reduce costs. It provides an overview of the importance of the quality movement and the definition of quality, including the concept of clinical and operational quality. Some national drivers for quality improvement as well as drivers of escalating health care costs are discussed, along with the urgency of reducing health care costs. The link between quality and cost is reviewed using the concept of value in health care, which combines quality and cost in the same equation. The article ends with a discussion of future directions of the quality movement, including emerging concepts, such as risk-adjustment, shared responsibility for quality, measuring quality at the individual provider level, and evolving legal implications of the quality movement, as well as the concept of a shared savings model.

[Indexed for MEDLINE]

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