The Community Quality Index Study, the largest and most comprehensive examination ever conducted of health care quality in the United States, found that adults fail to receive recommended health care nearly half the time. And everyone is at risk for receiving poor care . . .

• No matter where they live or why they sought care (Fig 1)
• What kind of insurance they have (Fig 2),
• Or what their race, gender, or financial status is (Fig. 3).

The gap between the care patients should be getting and what they actually get probably contributes to thousands of preventable deaths each year. Performance-tracking systems and health information technology could help the health system get a better grade.

To assess quality of care in this study, the research team developed the RAND Quality Assessment Tools, a set of measures and methods for “scoring” quality on a consistent and clinically sound basis.

Figure 1
Quality of Care Was Remarkably Similar Across the Metropolitan Areas Studied

Figure 2
All Groups Face Gaps in Care ... by Insurance

Figure 3
All Groups Face Gaps in Care ... by Status

SOURCE: RAND Research Brief 9053-2 (2006). The First National Report Card on Quality of Health Care in America