What, exactly, is Quality Health Care?

How do we measure quality within a health care system? Is it measured by greater access, lower cost, a combination of both, or none of the above? Is it even possible or responsible for us to use quantitative measures to make a qualitative assessment? It's not rare for researchers, companies, and/or individuals to convert qualitative assessments into quantitative measurements for the purpose of comparison. This technique has been the general "measuring stick" when comparing two different systems, groups, etc. to find what, how, or if changes need to be made or even if there is a need to start from the beginning all together. Though quantitative measures have been used in the past to compare general qualitative aspects of our lives, it is possible that the measure of "health care quality" cannot be measured with such general quantitative measures?

By its very nature health care quality is a (surprise!) qualitative value. This means that health care quality is a perception or opinion of the individual making the measurement. However, we simple cannot rely on qualitative values when we asses a health care system, so what are we to do? The biggest stumbling block is creating a clear definition and measurement tool for "quality" within a health care system.

The World Health Organization (WHO) measures quality as a "by product of access and cost". This means that a cheap and highly accessible health care system would be considered "quality" by the WHO standard. This, unfortunately, is the WORST definition of quality I have ever heard. There is no mention of outcomes or improvements to the individual or community and the WHO relies heavily on the individual to strictly follow doctors orders and receive scheduled check ups no matter what. This measurement seems to not take into account the massive amounts of variables life seems to continually throw at us on a daily basis. What about environmental, social, and education aspects of each community and individual?

Instead of measuring health care quality as a by product of cost and access, why not measure the outcomes of such health care systems? Measures such as overall health, quality of life (ie: absence of disease and illness), psychological stability (Maslow's Hierarchy of Needs), and other such measurements should be incorporated into what makes a health care system "quality". Though many would argue that such systems would only help to balloon the cost of health care or force companies to cut costs to increase revenue, there are many current examples that have proven that a more holistic/total approach to health care that addresses all aspects of a healthy life (education, security, physical/mental health) not only create happier individuals it can also significantly cut costs. Generally, these programs have accomplished such miracles by de-centralizing the health care apparatus, creating incentives for individuals who choose to have healthier lifestyles (yearly check-ups, eating properly, getting better exercise) both through financial and motivational incentives. Rather then focusing on the group, such programs focus on the entire health of the individual or community and tailor the system to meet the specific needs of the community. These programs have the increased flexibility to grow and adapt as the community or individual changes through time. To summarize, health care quality should focus on the individual's total health, not on the health of their bank account.