PT - JOURNAL ARTICLE AU - Donabedian, A TI - The quality of medical care AID - 10.1126/science.417400 DP - 1978 May 26 TA - Science PG - 856--864 VI - 200 IP - 4344 4099 - http://science.sciencemag.org/content/200/4344/856.short 4100 - http://science.sciencemag.org/content/200/4344/856.full SO - Science1978 May 26; 200 AB - 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.