Quality and cost in healthcare: a relationship worth examining.

Debate over healthcare often focuses on two key issues: quality and cost. However, because of the unique characteristics of healthcare, this relationship is not as simple as it might seem. A recent Supreme Court of Canada judgement directly addressing aspects of quality of care, combined with related government policy, provides an impetus for a review of research on quality as it affects costs of care. Our premise is that quality problems may not be the result of financing constraints but rather quality issues are a significant contributor to funding pressures. Theoretical and empirical evidence is reviewed and the implications for decision makers are discussed. A managerial focus on cost minimisation strategies makes implementing priority setting processes challenging because it calls for behaviours that typically counter professional self-interest. We suggest that a focus on quality would ultimately provide an effective strategy to contain costs, not to mention having a positive impact on patient well-being.