Quality of care and HIV infection: theory and practice

The first section of this article provides a brief, conceptually oriented overview of the "state of the art" in quality assessment. The second section examines what we know about quality assessment in HIV disease. The third section attempts to synthesize this information and make some practical recommendations. These recommendations are starting points on a road to understanding quality assessment in HIV disease, not a destination. Scant empiric data underpin these recommendations, and it is my expectation and hope that they will evoke discussion and debate. Although this article touches only briefly on quality improvement, decisions about what to do with the information gathered may be just as important as decisions about what to measure. The concepts described in the continuous quality improvement literature, even though they are only beginning to be applied to health care, may be an important guidepost on the road to improved quality.