PSRO impact: are the statements valid?

The generation of PSRO impact statements cannot simply be a "fill in the formula" routine. A health care system is not a simple environment, and narrow approaches to documenting change usually will not suffice. Instead, one would hope that future PSRO impact studies will take into consideration at least the concerns discussed here, as well as many others. As demonstrated in the New Mexico PSRO experiment, PSROs may not be able to demonstrate cost savings given the enormity and fragmentation of the health care environment. Such a conclusion should not result in a declaration of the PSRO program's failure but, instead, should serve to redirect the program's emphasis toward quality assurance, for which even the OPEL study noted impact.