A new study published in the Annals of Internal Medicine sought to review evidence of the association between health care quality and cost. The authors reviewed electronic literature search of PubMed, EconLit, and EMBASE databases for U.S.-based studies published between 1990 and 2012. Studies were categorized by level of analysis, type of quality measure, type of cost measure, and method of addressing confounders. The study concluded that evidence of the direction of association between health care cost and quality is inconsistent. Most studies have found that the association between cost and quality is small to moderate, regardless of whether the direction is positive or negative. Future studies should focus on what types of spending are most effective in improving quality and what types of spending represent waste.
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The Association Between Health Care Quality and Cost: A Systematic Review, Ann Intern Med. 1 January 2013;158(1):27-34