Most of the available evidence on adverse events comes from hospitals, because the risks associated with hospital care are high and strategies for improvement are better documented, and the paramount importance of patient trust. But many adverse events occur in other health care services, such as doctors' offices, private clinics, pharmacies and patients' homes. Recent publications also highlights the problems associated with outpatients, but data on magnitude of the problem outside the hospital are very rare.
An Internet search could help identify the best hospitals Americans in the field of pathology and recognizes that this method has risks and numerous biases. In short, obtaining objective information on his choice of doctor and hospital reference is a certain challenge to the patient's perspective. Mr. D. Howell provides an extensive review of the limitations the American system and attempts to answer the question the patient. Does the patient must choose a primary care physician or a specialist? On Epidemiologically, some authors have demonstrated that mortality decreased and life expectancy increases according to the increase in physicians primary care found in some states. To each additional primary care physician in a population of 10,000 souls, mortality Average decrease of 49 per 100 000.
The Government has realized the need for urgent action and taken to implement the priority national project "Health". It is planned that in the coming years in all Increasingly, the attention of politicians, sponsors, patients and businessmen will be directed at improving quality of care. Competition not only for the client, but also skilled staff will be grow at the same time will increase the need for effective management. One of the most effective tools overcome the challenges of the XXI century is a quality management (QM).