Donabedian A
Science. 1978 May 26;200(4344):856-64. doi: 10.1126/science.417400.
This article classifies the major approaches to the assessment of the process and outcomes of medical care. The apparent need to safeguard and enhance the quality of care has led to the institution of mechanisms that subject care to constant review so that deficiencies may be found and corrected. The article reviews the developments that led to the involvement of the federal government in this activity through its sponsorship of professional standards review organizations (PSRO's). The major features of the PSRO's are described and their possible effects discussed. It is too early to say how the PSRO's will fare, but should they fail to accomplish their objectives the pressure for more radical solutions will be difficult to resist.
本文对医疗护理过程及结果评估的主要方法进行了分类。保障和提高护理质量这一明显需求促使建立了相关机制，对护理进行持续审查，以便发现并纠正缺陷。本文回顾了一系列发展情况，这些发展使得联邦政府通过赞助专业标准审查组织（PSRO）参与到这项活动中来。文中描述了PSRO的主要特征，并讨论了其可能产生的影响。现在说PSRO将会如何发展还为时过早，但如果它们无法实现目标，那么采取更激进解决方案的压力将难以抗拒。
