Measuring the Quality of Health Care -- Copyright -- Preface and Acknowledgments -- ORGANIZATION OF THIS STATEMENT -- Contents -- Measuring the Quality of Health Care -- CAN QUALITY OF CARE BE DEFINED? -- Terms in the Definition -- What Is the Relationship Between Quality and Resource Constraints? -- WHERE DO QUALITY-OF-CARE CONCERNS LIE? -- Too Much Care: Unnecessary or Inappropriate Care -- Too Little Care: Underuse of Needed, Effective, and Appropriate Care -- Misuse: Shortcomings in Technical and Interpersonal Aspects of Care -- The Burden of Poor Quality -- WHAT ARE THE MAJOR APPROACHES TO QUALITY MEASUREMENT? -- Structural Measures of Quality -- Process Measures of Quality -- Outcomes Measurement -- The Importance of Linking Structure, Process, Outcomes, and Cost -- Measurement as a Continuous Process that Serves Multiple Purposes -- ADVANCES IN QUALITY MEASUREMENT -- Applying Research Methods to Address Real-World Quality Problems -- Combining Quality Measurement and Improvement to Reduce Adverse Drug Events -- Translating Clinical Guidelines into Useful Quality Measures -- The Development of Patient-Reported Measure of Quality -- Beginnings of Quality Measurement in Integrated Systems -- Amassing and Accessing the Burgeoning Toolkit of Quality Measures -- Infrastructure for the Development and Use of Measures -- Public-and Private-Sector Responsibilities -- Dissemination and Updating -- CHALLENGES -- Evaluating Measures -- Data Systems -- The Evidence Base of Medicine and Health Care -- Common Definitions and Measurement Methods -- Risk Adjustment -- Ensuring the Accuracy of Public Reporting -- Confidentiality -- The Cost of Quality Measurement, Improvement, and Poor Quality -- Who Is Responsible for Performance? -- CONCLUDING THOUGHTS -- References -- Committee Biographies.