5076.1: Wednesday, October 24, 2001 - 8:30 AM

Abstract #32883

You Can’t Leap a Chasm in Two Jumps: Reflections on the Institute of Medicine Healthcare Quality Report

Gordon D. Schiff, MD, Dept.of Medicine, Cook County Hospital, 1900 W. Polk St., Chicago, IL 60612, , gdschiff@aol.com and Quentin Young, MD, Cook county Hospital, Dept. of Medicine, 1900 W. Polk St., Rm 1600-AX, Chicago, IL 60612.

The IOM Committee on Quality of Health Care recently released a report which is a scathing indictment of the current state of health care quality. The IOM authors present evidence for this conclusion, and offer thirteen recommendations for change.

Despite its sweeping overview, there is insufficient emphasis on several areas critical to understanding and changing current quality-impairing realities. While the Committee mentions "equity" as one of its six key attributes, there is little discussion of the role of a unified universal finance system (eg single-payer national health insurance) in achieving this end. The Report’s financing discussions instead dwell on tinkering with financial incentives. We argue that nurses and doctors need support, in the form of time, training, information, and practical timely guidance, not better sticks and carrots.

The Report recommends improving care to patients with chronic diseases, yet fails fully convey how such patients have been eschewed and abused by insurers and at-risk captiations arrangements that reward such undesirable practices.

As economic disparities increase, factors bonding quality for all patients become frayed. Without a more equitable system, "highest quality care" will continue to be confused with preferential treatment in a marketplace that allocates multi-tiered care based on ability to pay.

Learning Objectives: 1. Understand the IOM Health Quality Report and the implications for quality of care.

Keywords: Health Reform,

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA