The concept of quality can be a tricky thing to define. An
acceptable level of quality can be different for many people depending on
whether they try to define it for a good or a service, and even then quality
can vary. Researchers have developed six dimensions of quality that make up
care: safety, effectiveness, efficiency, timeliness, patient centeredness, and
equality. In a healthcare setting, these dimensions can mean something
completely different to each stakeholder asked, including patients, doctors,
staff, and insurance providers. Each of these groups of people may have a
different idea about the level of quality that is acceptable in a healthcare
environment.
Patients,
on one hand, most likely want to receive the highest possible level of quality.
Due to medical advancements in recent years, patients have come to enjoy the
newest procedures and tests available; however, these advancements come at a
higher cost and patients often do not want to or are unable to cover the increasingly
high costs of care. Doctors may have another idea of quality altogether. While
a patient may feel that a long wait time is an indicator of low quality, a
doctor may deem the long wait time necessary. Additionally, insurance companies
may not feel that certain tests or procedures are necessary for a patient’s
care and can refuse to cover them.
There are
many problems with the quality of care in healthcare organizations. Although no
organization is perfect, these three problems can occur anywhere. Underuse
occurs when good practices are not used as often as they are needed. An example
of underuse is when a necessary test or procedure, often preventive in nature,
is not provided or offered to the patient. If a patient is uninformed, as it is
easy to be in the complicated healthcare world, it is up to the doctor to
explain all the options for care. Overuse is another problem with quality and
occurs when procedures or tests that are not necessary are used. This overuse
can be invasive to the patient and can also unnecessarily drive up the cost of
care. Finally, misuse is a healthcare quality problem in which the wrong care
is delivered. This can occur when the wrong drug is administered to a patient
or the wrong amount is given. Misuse also occurs when a doctor prescribes drugs
to a patient who clearly does not need them, such as in pill-mill situations.
To me, high
quality means that the patient receives the best care possible within the six
dimensions of care mentioned above and there is little to no overuse, underuse,
and misuse of care. Of course, there must be a balance between the quality and
cost of care as some may be able to pay a higher cost for better services. This
does not mean that only those who can afford high quality care should be the people
to receive it. I believe that all people deserve good medical care and all
tests and procedures necessary to live a healthy life; however, there must be
standards for the minimum quality of care for those who may be financially
unable to afford the “best” quality care.
