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Gerald W. Peskin, MD

Arch Surg. 2002;137:13-14.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

During the past several years, one of the most perplexing issues for surgeons has been the assessment of quality of care. We, however, owe it to ourselves and our patients to master the substantive issues that underlie current discussions about this subject. What is quality care? Many definitions have been proposed. Donabedian developed the classic triad for measuring quality in health care: structure, process, and outcome. Structural data are characteristics of physicians and hospitals (eg, specialty of physicians, ownership of hospitals). Process data result from an interaction between physician and patient (eg, tests ordered). "Outcome" refers to the subsequent health status of the patient (eg, improvement in gastrointestinal function). To be credible, structure and process must lead to differences in outcome, and outcome data, to be valid, must show that differences will result if processes of care, under the control of the provider, are modified. There . . . [Full Text of this Article]

From the Department of Surgery, University of California, San Francisco–East Bay, Oakland.

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