Resources & Tools
What Is Quality?
Many people make the wrong assumptions about what it means to get good medical care. Here's the truth:
- More care does not equal better care. For example, computed tomography scans — also known as CT or CAT scans — provide very detailed images of your bones and tissue. The results of these scans can be very helpful but are not always necessary. The scans expose patients to radiation that puts them at higher risk for developing cancer. Recent research has shown that even one CT scan increases the odds that a person will develop cancer. So these scans should be used more selectively than they are now.
- More expensive care is not necessarily better care. If your hospital charges more than other hospitals, it doesn't mean the care you receive will be better — or that the doctors and nurses will work harder. Another example is prescription drugs: The only difference between name-brand drugs and generic drugs is the price. Both are made of the same active ingredients, but the price difference can be extreme. A name-brand drug makes sense when it's new enough that there isn't a generic version yet, but otherwise, it's usually not worth the extra cost.
- The latest care is not always the greatest care. Americans like new technology, especially when it comes to medicine. But often we discover that tried and true care is better than the latest and greatest. For example, hip and knee joint replacements are a common surgery. Several years ago, a new metal-on-metal hip joint was created; developers thought it was more durable than the metal-on-plastic versions. Many of these new joints were used. Later it was discovered that metal debris from the metal-on-metal implants was causing pain and joint problems for patients, requiring a second operation to replace them. Eventually, the metal-on-metal joints were taken off the market. Problems like this happen when we adopt new technology before testing it thoroughly.
High-quality care means that to get the best results, medical providers do the right thing, at the right time, in the right way, for the right person.
Experts agree that there are six key components of health care quality. According to the Institute of Medicine (an independent, nonprofit organization that provides unbiased advice to decision-makers and the public), quality health care is:
- Safe: Making sure patient care is helpful and not harmful
- Effective: Providing proven services only to patients who can benefit from them and not to those who can't (avoiding underuse, overuse, and misuse)
- Patient centered: Providing care that respects and responds to each patient's preferences, needs, and values — and using these guidelines to make decisions
- Timely: Reducing delays that can prove harmful
- Efficient: Avoiding the waste of equipment, supplies, time, and money — waste that can affect you and others
- Equitable: Providing equal care for every patient, regardless of gender, ethnicity, geographic location, social status, or economic status
At CalHospitalCompare.org, we focus on the first four components: patient safety, clinical effectiveness, patient-centered care, and timely care. We don't address the last two components because useful information isn't available yet. Measuring health care quality is a relatively new field — when more information on these components becomes available, we'll add it to CalHospitalCompare.org.