Measuring quality of surgical care: is it attainable?

SUMMARY: Healthcare quality has emerged as an important discussion topic for the American people. With the continued lack of health insurance coverage for over 15 percent of Americans, questions are being posed regarding why the United States has spent $2.1 trillion per year in healthcare and is still unable to provide the highest quality of healthcare in the world. The World Health Organization's 2000 World Health Report ranked the United States at 24 out of 191 member countries in healthcare indices. Because of a looming reduction in the number of Americans covered through the Medicare and Medicaid programs due to budgetary constraints, many initiatives have been proposed to cut the cost of healthcare and at the same time improve the quality of the American system. In this article, the authors summarize the history of these quality initiatives and discuss current and future directions of programs to achieve better healthcare for the country. They also discuss how the American Society of Plastic Surgeons is engaging national organizations to be part of the solution for this crisis.