Measuring the Quality of Neurologic Care in the United States: There Is Room for Improvement

Suboptimal quality of care and rapidly increasing health expenditures are 2 fundamental conundrums of the United States health system. Although the United States spends more on health care than any other developed country, the quality of care patients receive in the United States may be substandard. A seminal study conducted by McGlynn et al.1 in 2003 showed that American patients received recommended care only 55% of the time. Quality improvement initiatives have led to marginal improvements. The percentage of Americans who received recommended care rose from 66% in 2005 to 70% in 2010,2 and the risk-adjusted mortality rates 30 days after discharge declined from 8.4 in 2010 to 6.1 in 2018.3,4 However, there clearly is room for improvement in the quality of care delivered in the United States, warranting more rapid and substantial changes. The degree of needed improvement may vary across specialties.

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