Change in the Quality of Care Delivered to Medicare Beneficiaries, 1998-1999 to 2000-2001

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Abstract
Health care in the United States can be improved substantially, and even people with apparently good access to care receive care that falls far short of what it could be. In the area of public health and prevention, Healthy People 20101 showed wide gaps between public health performance and actual achievements on many quality indicators, including some delivered by the fee-for-service health care system. Two years ago, a report from the Institute of Medicine showed serious problems of harm to patients from medical errors2; last year another Institute of Medicine report, Crossing the Quality Chasm,3 identified major system problems as the principal source of many errors. In 2000, Congress instructed the Agency for Health Care Research and Quality to prepare an annual report on quality of health care in the United States, and the first of these reports is scheduled to be made public next year.