title: No Toyotas in health care: why medical care has not evolved to meet patients' needs.
abstract: The incentives and structure of health care in the United States produce exactly what we should expect in the quality of care for chronic disease: highly variable patterns of care and widespread failure to implement evidence-based best practices. The persistent inability of providers to improve patterns of practice is due in part to the lack of a "business case for quality." Providers cannot anticipate that quality improvements will result in higher prices, increased volume, or decreased costs. However, signs of a business case for quality are emerging, fueled by cost pressures, the increased availability of data, informed consumers, and public- and private-sector purchaser initiatives.
authors.affiliation: Health Technology Center, San Francisco, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Coye
mesh_terms: D002908:Chronic Disease / Q000191:economics / Q000628:therapy*; D003132:Commerce; D019981:Health Care Sector / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D006301:Health Services Needs and Demand; D006801:Humans; D010818:Practice Patterns, Physicians'; D011785:Quality Assurance, Health Care / Q000191:economics*; D012051:Reimbursement Mechanisms; D012941:Social Responsibility; D014481:United States