This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (6)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Do We Always Get What We Pay For?

Edward H. Wagner, MD, MPH

JAMA. 1994;272(24):1951-1952.

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

The relationship between cost and quality is more than an academic concern. Assumptions about the strength and direction of the association are at the heart of the current debate about the future direction of American health care. If we assume that quality and costs are positively related, then it follows that efforts to contain costs threaten quality.¹ If we assume a less linear or even negative relationship, then cost containment and quality improvement may even be complementary.²

See also p 1903.

Donabedian et al³ suggest that the use of health services beyond those needed for maximum health benefit might actually have a negative effect because of complications of the unnecessary tests and treatments. Empirical studies of the cost-quality relationship have been largely confined to hospital care and show no consistency in the direction of the associations.⁴ The article by Starfield et al⁵ in this issue . . . [Full Text PDF of this Article]

Author Affiliations
From the Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, Wash.

Footnotes
Reprint requests to Center for Health Studies, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1448 (Dr Wagner).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?