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Competition and quality: rhetoric and reality

¹York Health Economics Consortium, University of York, UK. akm3@york.ac.uk

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care

|November 25, 1998

Summary

Healthcare systems in the USA and UK prioritize cost and process over patient health outcomes. Policies fail to define, measure, or implement quality improvements, hindering continuous progress.

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Area of Science:

Health Services Research
Healthcare Management
Health Policy Analysis

Background:

Healthcare systems globally, including the USA and UK, often focus on cost and process efficiency.
There is a disconnect between the rhetoric of quality improvement and its practical implementation in healthcare decision-making.

Purpose of the Study:

To examine the behaviors of decision-makers in the USA and UK healthcare systems regarding quality outcome policies.
To explore the causes behind the failure to define, measure, and implement quality outcome policies.
To analyze the effectiveness of competition in driving quality improvement in healthcare.

Main Methods:

Comparative analysis of healthcare system management in the USA and UK.
Examination of policy implementation failures in public and private healthcare markets.
Exploration of the role of competition in healthcare quality outcomes.

Main Results:

Both USA and UK healthcare systems are managed based on cost and process, not patient health status.
Governments and insurers fail to define, measure, and implement quality outcome policies.
Competition in healthcare markets does not effectively identify quality targets or motivate quality improvement.

Conclusions:

A significant policy challenge is the measurement and practical management of healthcare quality outcomes.
Current healthcare management strategies are not effectively oriented towards continuous quality outcome improvement.
Addressing the gap between quality measurement and its integration into practice is crucial for advancing healthcare.

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