[Quality and shortages of patient safety--how reduce the costs?]

There is a sizable "poor quality and safety" problem in health care, not only in terms of suffering to patients but also in economic terms. Few studies have assigned costs to the problems. Decisions about whether to take action and which actions to take would be assisted by economic evidence. The article presents research which shows subjects and services where there is evidence both of poor quality and of effective interventions The article shows ways systematically to incorporate economic considerations into decisions about improvement and practical methods for estimating the costs of a quality problem and possible savings. A simple method is presented which would allow a purchaser or provider to make a comprehensive overview of a range of healthcare problems to help decide where to invest resources to save costs. Economic criteria and estimates, however, should not be the only criteria for selecting improvement subjects. Understanding of the costs of both the problem and the solution would encourage more effective quality and safety improvement and provide one way of measuring the progress of an action to solve the problem.