Public policy and quality of healthcare

Anaesthesiologists have long been interested in improving the quality of clinical care. However, clinical care is but one contributor to healthcare quality, which is influenced by a wide range of factors including health policy, health system funding, and organization. It is the interaction between these drivers and a nationʹs social and economic conditions (such as education and personal income) that determines the populationʹs health. Whereas public debate has focused on healthcare funding, health systems face similar problems in achieving the best outcomes most affordably. The ability to measure outcome is limited in most jurisdictions, mainly by the lack of information systems. Nevertheless, public reporting of quality indicators has increased. Affordability is threatened by new technologies, population growth and ageing. This threat is creating renewed interest in prevention and population health, particularly through the use of leading indicators. With this interest in population health, the role and education of physicians may need to change.