TABLE 1

National Health Care Quality Report Matrix: Combines 4 of the IOM Health Care Quality Components and the FACCT Consumer Perspectives on Health Care Needs, With Equity as the Third Dimension

Consumer Perspectives on Health Care NeedsComponents of Health Care Quality
SafetyTimelinessEffectivenessPatient-Centeredness
Staying healthyFluoride only when neededAccess to well-child careImmunizationsSocial history assessment
Getting betterDrug-allergy check before prescribing medicationsAccess to urgent careAppropriate antibiotics for upper respiratory infectionsFamily involvement during hospital rounds
Living with illness or disabilityMedication reconciliationAccess to long-term careInhaled steroids for persistent asthmaFamily involvement in developing long-term plan of care
Coping with the end of lifeAvoid unnecessary painful interventionsAccess to hospice careEffective end-of-life pain managementAdvance directive
  • Components of health care quality include (1) safety: "avoiding injuries to patients from care that is intended to help them"; (2) effectiveness: "providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit (avoiding overuse and underuse)"; (3) patient-centeredness: establishing "a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients' wants, needs, and preferences"; and (4) timeliness: "obtaining needed care and minimizing unnecessary delays in getting that care." Consumer perspectives on health care needs include (1) staying healthy: preventive care; (2) getting better: acute care; (3) living with illness or disability: chronic care; and (4) coping with the end of life: end-of-life care. Equity is "a crosscutting issue" that is "the provision of health care of equal quality to those who may differ in personal characteristics that are not inherently linked to health, such as gender, ethnicity, geographic location, socioeconomic status, or insurance coverage" and means that "quality of care is based on needs and clinical factors."