Is quality of health care a meaningful guide?

Health care consumers are beginning to learn that "what you don't know can hurt you." Though consumers consistently rank quality of care as an important attribute, "quality of care" does not appear to be particularly useful in decision making. The quality of health care is difficult to measure, communicate, and interpret. Yet if consumers are to make efficient choices including both value and cost in their decisions, quality information must be available to them. This paper outlines a scheme to conceptualize quality of care and suggests some ways to operationalize measures of quality that could provide empirically based indices of quality of care to facilitate health care consumer decision-making.