Quality assurance: a literature review of a changing field.

The activities and interests of quality assurance programs have changed dramatically in recent years, in response to the government's, the public's, and the health care field's concerns with spiraling health care costs and diminishing health care funds. Using the recent literature on quality assurance in the mental health field, the author discusses how a changing political and social climate has affected the evolution of quality assurance programs--who runs them and who participates in them, what activities they encompass, their methodological challenges, how they have coped with their new responsibilities, and what lies ahead for them.