The relationship between the cost and quality of hospital care: a review of the literature.

care costs must be controlled-but not at the expense of a deterioration in quality of care. The truth is that nobody really is sure to what extent costs can be cut while at the same time maintaining or improving quality. The crux of the argument depends on whether gains in efficiency are possible or whether efficiency has essentially been &dquo;squeezed out&dquo; of the system by prospective payment and other cost-controlling measures. This review focuses on the theoretical and empirical studies that have attempted to relate the two concepts, quality and cost. It should be