[Quality assurance and cost containment--counterproductive or synergistic effects?]

Quality of care and cost considerations are becoming increasingly intertwined. While costs were an insignificant factor in quality management 30 years ago, today the consumption of resources is a measure of the quality of outcome. Newly developed clinical guidelines are intended to reduce the cost of care in the future. However, they entail a significant potential for abuse that can compromise quality. Guidelines are necessary to demonstrate the cost effectiveness of quality control and quality assurance measures. Excessive emphasis on quality assurance may increase the overall consumption of resources. In a managed care setting with budgetary constraints, this can reduce the quality of care.