Quality-can we measure it.

Assuring the quality of care is rapidly becoming a big business. Considering both the PSRO program with its Medical Care Evaluation studies and the Joint Commission of Hospital Accreditation with its Performance Evaluation Procedure audits, about 50,000 audits concerning quality of inpatient care will probably be performed in 1977. At an estimated $5,000 per audit, expenditures of about $250 million are already occurring. The extent to which such spending will contribute to improvements in health remains ambiguous, however. In this issue of the Journal, Nobrega and his colleagues question the validity of the method of explicit process criteria, which . . .