Holcomb J
Tex Med. 2000 Oct;96(10):48-52.
Changes in the financing and delivery of health care in the 1980s, originally driven by ever-escalating costs, led to increasing demands for accountability from providers to payers and consumers. The inability of the health care industry to articulate a vision, or even a definition of quality of care, allowed the promulgation of the use of extant data sources (claims data) in efforts to define quality. Although such data sources are limited in their ability to measure quality of care, the application of increasingly sophisticated computer algorithms has led to widespread public reporting of such information and a need for physicians to understand and participate in efforts to measure and report outcomes of medical interventions.
20世纪80年代医疗保健融资和服务提供方式的变化最初是由不断攀升的成本推动的，这导致了提供者对付款人和消费者的问责要求日益增加。医疗保健行业无法阐明护理质量的愿景甚至定义，使得人们开始使用现有数据源（索赔数据）来定义质量。尽管这些数据源在衡量护理质量方面能力有限，但日益复杂的计算机算法的应用导致了此类信息的广泛公开报告，也使得医生需要理解并参与到衡量和报告医疗干预结果的工作中。
