Quality of Care for Oncologic Conditions and HIV: A Review of the Literature and Quality Indicators

Developing and implementing a valid system of-quality assessment is essential for effective functioning of the health care system. Although a number of groups have produced quality assessment tools, these tools typically suffer from a variety of limitations. Information is obtained on only a few dimensions of quality, the tools rely exclusively on administrative data, they examine quality only for users of services rather than the population, or they fail to provide a scientific basis for the quality indicators. Under funding from public and private sponsors, including the Health Care Financing Administration (HCFA), the Agency for Healthcare Research and Quality (AHRQ), the California HealthCare Foundation, and the Robert Wood Johnson Foundation (RWJ), RAND has developed and tested a comprehensive, clinically based system for assessing quality of care for children and adults. We call this system QA Tools. In this introduction, we discuss how the clinical areas were selected, how the indicators were chosen, and what is included in the overall system. We then describe in detail how we developed the indicators for children and adolescents.