comparing and contrasting the measures of quality for each of the countries.

Prepare a 3- to 5-page paper comparing and contrasting the measures of quality for each of the countries discussed in this module. Some of the measures you can discuss are morality, readmissions, safety of care, patient experience, effectiveness of care, timeliness of care, efficient use of medical care, and others.

Be sure to identify the features that constitute quality in these countries. What is preventing quality from being achieved and how can this be fixed?

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Comparing and contrasting for Canada, Mexico, Peru, Brazil along with the United States

Measures of Quality
Course name
Johanna Laguerre
Professor: Dr. Tracy Smith
Thomas Edison State University
Date: February 05, 2023
The United States healthcare system is facing numerous challenges in terms of quality
and accessibility. While the country has some of the best medical facilities and healthcare
professionals, several factors contribute to inadequate quality of care. To assess the quality of
care in the United States, various aspects must be considered, including morality, readmissions,
the safety of care, patient experience, the effectiveness of care, timeliness of care, efficient use of
medical care, and others.
Morality in the United States healthcare system refers to the death rate of patients while
undergoing medical treatment. According to the World Health Organization (WHO, 2021), the
United States ranks 27th in terms of morality, which suggests that the quality of medical care in
the country is not on par with the best in the world. This can be due to several factors, including
a lack of access to medical care for certain populations, a fragmented healthcare system, and
higher costs of care compared to other developed nations.
Additionally, disparities in healthcare quality between racial and ethnic groups have been
well documented (Smedley et al., 2002). For example, African Americans have higher mortality
rates for many illnesses compared to non-Hispanic whites, despite having similar access to
medical care (Smedley et al., 2002). This disparity highlights the need for targeted efforts to
improve the quality of care for minority populations in the United States.
Studies have shown that readmissions remain a significant problem in the U.S. healthcare
system. According to the Agency for Healthcare Research and Quality (AHRQ), approximately
20% of Medicare beneficiaries are readmitted within 30 days of their initial discharge from the
hospital (AHRQ, 2021). This high rate of readmissions contributes to increased healthcare costs
and reduced quality of life for patients.
The safety of healthcare in the United States is a complex and multifaceted issue. While
the country has some of the world’s leading medical facilities and highly trained healthcare
providers, the overall safety of care has been criticized and is a subject of ongoing improvement
efforts. There are concerns about medical errors, patient harm, infections, and medication-related
adverse events. Additionally, disparities in access to quality healthcare persist, leading to
unequal health outcomes for certain populations. Efforts to improve patient safety and reduce
harm in healthcare settings include increased patient involvement in their care, increased
transparency in reporting and analyzing medical errors, and the adoption of evidence-based
practices and technologies. Studies have shown that patient safety remains a major concern in the
U.S. healthcare system. According to the National Patient Safety Foundation (NPSF), medical
errors are estimated to occur in 1 out of every 10 hospital admissions (NPSF, 2021). This high
rate of medical errors can lead to adverse events such as harm, injury, or death.
Patient experience in the United States varies greatly depending on many factors,
including access to healthcare, insurance coverage, and personal circumstances. However, some
common issues affecting the patient experience include long wait times, difficulty
communicating with healthcare providers, and a perceived lack of empathy or personalized
attention. There is also evidence of racial and socioeconomic disparities in healthcare
experiences, with marginalized communities often reporting poorer experiences and lower
satisfaction with their care.
The effectiveness of healthcare in the United States is a complex issue that has received
significant attention from researchers and policymakers. The U.S. healthcare system lags behind
other countries in terms of access to care, patient safety, and coordination of care, among other
measures of healthcare quality (Schoen et al., 2019). The findings of this report highlight the
need for continued improvement in the U.S. healthcare system. Despite the country’s significant
investment in healthcare, patients still face significant barriers to receiving high-quality, effective
care, including long wait times, difficulty coordinating care among multiple providers, and
disparities in access to care based on race, ethnicity, and income.
The timeliness of care in the United States is an important aspect of the overall quality of
healthcare, as patients expect to receive care on time that meets their needs. However, recent
studies have found that wait times for medical appointments and procedures can be significant in
some areas of the country. For example, a study conducted by the Agency for Healthcare
Research and Quality (AHRQ) found that over one-third of primary care patients in the United
States reported wait times of over 20 minutes to see a doctor, and nearly one in five reported wait
times of over 30 minutes (AHRQ, 2020). The study also found disparities in wait times based on
insurance status, with uninsured patients reporting longer wait times compared to those with
The efficient use of medical care, which refers to the effective and appropriate use of
resources in delivering healthcare services, is an ongoing challenge in the United States. Despite
being one of the world’s largest healthcare markets, the country continues to grapple with high
healthcare costs and widespread waste in the system. A recent report from the Institute of
Medicine (IOM) estimated that approximately 30% of healthcare spending in the United States is
wasted, largely due to inefficiencies in care delivery and overuse of medical services (IOM,
The quality of care in the United States is prevented from reaching its full potential due
to a complex and interconnected set of factors, including:
● Access to care: Despite significant investment in healthcare, many Americans still face
barriers to accessing care, particularly those from low-income and marginalized
communities (Kaiser Family Foundation, 2019).
● Cost: High healthcare costs can prevent patients from receiving the care they need, and
also contribute to waste in the system. “The U.S. spent nearly 18% of its Gross Domestic
Product on healthcare in 2016, a higher share than in any other country” (OECD, 2017).
● Provider shortages: In some areas of the country, there are shortages of healthcare
providers, which can lead to long wait times and difficulty accessing care. “Rural areas in
particular face provider shortages, with approximately 20% of rural populations living in
areas with a shortage of primary care providers” (National Rural Health Association,
● Disparities in care: Significant disparities in the quality of care received by different
populations, particularly those based on race, ethnicity, and income, persist in the United
States. “Black Americans, for example, are more likely to experience disparities in care,
including lower rates of access to care and higher rates of chronic conditions” (National
Academy of Medicine, 2019).
● Fragmented care: Inadequate coordination of care between providers and across the
healthcare system can lead to duplicative tests, procedures, and treatments, and can
impact the overall quality of care received by patients (Institute of Medicine, 2011).
To fix the quality of care in the United States, several measures can be taken:
● Increasing access to care: This can include expanding insurance coverage, increasing
funding for community health centers, and addressing provider shortages.
● Containing costs: Efforts to reduce waste and inefficiencies in the healthcare system can
help to contain costs, while still ensuring that patients receive high-quality care (Harvard
Institute, 2018).
● Addressing disparities in care: Addressing disparities in the quality of care received by
different populations can improve the overall quality of care in the United States
(National Academy of Medicine, 2019).
● Improving coordination of care: Efforts to improve care coordination, such as through the
use of health information technology, can help to reduce duplicative tests, procedures,
and treatments and improve the overall quality of care received by patients(Agency for
Healthcare Research and Quality, 2018).
● Investing in quality improvement: Ongoing investments in quality improvement
initiatives and research can help to identify best practices and promote continuous
improvement in the quality of healthcare in the United States (Harvest Institute, 2018).
Agency for Healthcare Research and Quality (2018). Health Information Technology (IT) and
Patient Safety.
Agency for Healthcare Research and Quality. (2020). Timeliness of Care.
AHRQ. (2021). Readmissions. Agency for Healthcare Research and Quality.
Harvest Institute (2018). Improving Efficiency in the Healthcare System.
Institute of Medicine (2011). Improving the Quality of Health Care for Mental and
Substance-Use Conditions.
Jha, A. K., Orav, E. J., & Epstein, A. M. (2013). Hospital quality and readmissions. JAMA,
309(17), 1813-1814.
Kaiser Family Foundation (2019). Nearly 30 Million People Remain Uninsured in 2018.
OECD (2017). Health spending per capita (indicator). doi: 10.1787/aec5b0da-en (Accessed on
National Rural Health Association (2020). Provider Shortages in Rural America.
National Academy of Medicine (2019). Health and Healthcare Disparities in the United States.
NPSF. (2021). Patient Safety. National Patient Safety Foundation.
Smedley, B. D., Stith, A. Y., & Nelson, A. R. (2002). Unequal treatment: Confronting racial and
ethnic disparities in health care. National Academies Press.
Schoen, C., Collins, S. R., Lissauer, D., Rechtsteiner, E. A., Kriss, J. L., Doty, M. M., &
Emerson, J. (2019). Mirror, Mirror 2019: A Summary of Findings on the State of Health
Care Quality. Commonwealth Fund.
World Health Organization. (2021). Mortality. Retrieved from

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