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Edward L. Hannan, PhD

JAMA. 2000;284:2374-2376.

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

A decade ago, the Institute of Medicine defined quality of care as ". . . the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge."¹ This definition is complex and comprehensive, and its many facets are described in detail in an article by Chassin et al² based on the consensus of the Institute of Medicine's National Roundtable on Health Care Quality. For instance, for "health services for individuals and populations to increase the likelihood of desired health outcomes" they must be used both appropriately and effectively. Quality-of-care problems related to undesirable health outcomes can arise as a result of underuse, overuse, or misuse.²

Underuse is defined as "failure to provide a health care service when it would have produced a favorable outcome for a patient."² There is considerable evidence of underuse of . . . [Full Text of this Article]

Author Affiliation: Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York at Albany, Rensselaer, NY.

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