Poor quality of healthcare services accounts for two-thirds of preventable deaths across low- and middle-income countries, despite improvements in access and financial protection. While strict quality standards and assurance are insisted on for health products like drugs and devices, the same is not emphasized for healthcare services.

Institute of Medicine, in its seminal report, ‘To err is human: Building a safer health system’,  published in 1999, brought out the disturbing fact that nearly 98,000 people die every year across US hospitals due to preventable medical errors. The report ushered in the movement for quality of care across health systems, making quality accreditation of providers mandatory to assure safe and effective healthcare services in many advanced countries. However, there are many countries, including India, that do not mandate quality accreditation for hospitals, clinics, and diagnostic laboratories.

As governments defaulted on their fundamental responsibility to provide the needed healthcare, private provider systems grew in an unregulated fashion to meet the unmet healthcare needs of people. While this improved access to healthcare, especially in urban locations, the quality of care that is provided is highly variable across providers. Owing to either governmental apathy or a lack of capacity to regulate powerful provider groups, many health systems lack mandated quality accreditation of their providers.

There is a gradual shift to the consolidation of payor pools through public and private health insurance systems across countries as part of their push toward achieving universal health coverage (UHC). Large payors are well positioned to demand quality assurance from providers as part of the empanelment. However, in supplier-driven markets, the insurance players are not in a position to demand quality assurance. There have been attempts at incentivizing providers for quality accreditation with reasonable results.

Governments will not be able to regulate private healthcare providers, if public providers are also not mandated for quality accreditation. Unless the quality of care is enforced across public and private providers, it will not arrest thousands of preventable deaths and disabilities due to unsafe, non-timely, and ineffective care.

Hence, it is time that every healthcare provider is mandated to obtain quality accreditation to protect unsuspecting patients from unsafe and poor-quality care. While quality assurance adds to the cost of care, the economic and health benefits clearly outweigh the incremental costs. Health regulation coupled with financial incentives will succeed in the adoption of quality systems by the providers.    

Dr. Krishna Reddy Nallamalla
President, InOrder President (Asia),
ACCESS Health International

Photo Credits: – Unsplash/ National Cancer Institute

Share This