The Performance Of The United States Health Care System

The performance of the United States health care system on both cost and quality has long been a subject of controversy with some arguing that it’s the best in the world, but others, increasingly well-armed with international comparisons, making the case that health care in the US is consistently underperforming, particularly considering the relative level of health care expenditures. Perhaps less arguable is the fact that we have not fully realized the hope that a common quality measurement and reporting system would galvanize and accelerate broad improvement, both at the level of institutions as well as health systems. There has been notable progress in a limited range of outcomes, such as cardiovascular mortality and central line-associated bloodstream infections, but improvement in US health care remains spotty and slow in all aspects of the six Institute of Medicine (IOM) dimensions at the national and state levels. , The persistence of large disparities in quality of c are and dismal progress in closing equity gaps is especially discouraging. Much more is needed and should be possible if we can more effectively link quality measurement and improvement. The mantra â€Å"You can’t improve what you don’t measure† — frequently attributed to W. Edwards Deming — has driven the relentless push toward routine assessments of the quality of care as fundamental to systematically improving health system performance. 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