Linking Costs and Quality in Healthcare: Towards Sustainable Healthcare Systems Comment on "Hospitals Bending the Cost Curve With Increased Quality: A Scoping Review Into Integrated Hospital Strategies".

Organisation-wide studies in cost and quality of care are rare, and Wackers et al make a valuable contribution in synthesizing the literature on this issue. Their paper provides a good overview of initiatives and a list of factors that help in furthering organisation-wide change. The eleven factors they distill from the literate however remain rather abstract and more work needs to be done to contextualize the factors and the work that is needed to accomplish them and to see how they are aligned. Challenges in healthcare quality and costs moreover increasingly cross organizational boundaries and we need new methods to study and evaluate these.