Methods to assess the quality of care for elderly patients with pneumonia.

During the past several years, interest has focused on the cost and quality of health care. The elderly represent an important population to study since they are less resilient to the effects of acute illness such as pneumonia, and if they receive improper care, these patients will be more sensitive to that poor care and more likely demonstrate measurable ill effects. This article examines several methods to assess quality. The traditional method addresses the process of care or whether the patient received the appropriate care for his or her particular condition. Process of care evaluations either rely upon the subjective judgment of expert clinicians or use sets of explicitly defined criteria. A second quality assessment method examines the patient outcome, ie, regardless of the care received, did the patient get well? Each of these methods has strengths and limitations. Based upon this understanding, the article will describe a multimodality approach to the assessment of quality.