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Quality and cost: choices and responsibilities.

A Donabedian

    Inquiry : a Journal of Medical Care Organization, Provision and Financing
    |January 1, 1988
    PubMed
    Summary

    Healthcare providers balance effective, efficient care with patient preferences. Societal standards for optimal care may lead professionals to oppose, adopt, or mediate between social mandates and patient advocacy.

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    Area of Science:

    • Healthcare Economics
    • Medical Ethics
    • Health Policy

    Background:

    • Healthcare practitioners aim for efficient and effective patient care.
    • Patient preferences can influence care decisions, potentially diverging from maximum efficacy when costs are high relative to benefits.

    Purpose of the Study:

    • To explore potential responses of healthcare professionals to externally imposed societal standards for optimal care.
    • To analyze the ethical considerations when societal goals for healthcare differ from individual patient needs or practitioner judgment.

    Main Methods:

    • Conceptual analysis of ethical obligations in healthcare provision.
    • Exploration of professional responses to policy interventions in medical practice.

    Main Results:

    • Practitioners may resist societal standards, fully adopt them, or seek a middle ground.
    • A potential intermediate approach involves accepting societal guidelines while preserving the practitioner's role in patient advocacy and the profession's role in public good advocacy.

    Conclusions:

    • Societal interventions in defining optimal healthcare must consider professional and patient roles.
    • Healthcare professionals' responses to new standards will likely involve a complex negotiation of efficiency, efficacy, patient autonomy, and professional ethics.
    Keywords:
    Health Care and Public HealthProfessional Patient Relationship

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