The link between cost and quality of health care still remains unclear when it comes to the improvement of health care. This is due to the fact that most of the discussions revolve around the twin pillars of quality and cost; for instance, it is analyzed whether higher expenditures will result in a better quality health care or whether better health care will help to decrease the costs. Given the views that good health care helps to get good value for the money, a concept concerning the value of health care incorporates both costs and quality.
A number of studies demonstrate a large gap between what is known to be an effective care and what is actually received by patients regardless of their pay. Addressing the health care costs and quality issues, the Agency of Healthcare Research and Quality, which is a Federal agency, supports the research designed to improve the health care quality by reducing its costs. The agency sponsors study that provides evidence-based information on health care quality and cost. The organization works towards improving the health care quality by maintaining the good things in the existing health care system. The top-priority target of the AHRQ is to improve the quality of the care provided and reduce the medical costs (Agency for Healthcare Research and Quality, 2002). In contrast, the National Quality Strategy, a public agency, addresses the issue of quality and control by seeking to build a national consensus on how quality can be measured to maximize results. Moreover, the NQS works towards reducing quality care costs for individuals, families and the government through an Affordable Care Act. This calls for an establishment of a national strategy aimed at improving health care service delivery, health outcomes of patients, as well as the population health.
On the contrary, The Joint Commission, a private agency, seeks to improve the quality of care through health care accreditation provision of health care organizations. The Joint Commission works collaboratively with organizations using data to improve the quality of health care, improve patient outcome and reduce associated costs for health care (Berman, 1999). In addressing health care quality and cost, the Joint Commission uses measuring activities in identifying, implementing and improving health care.
A number of health care initiatives, such as Medicare, were designed to deal primarily with acute illnesses. While the project has generally fulfilled this purpose, it has now faced the challenge of dealing with the issues of costs and quality of health care. The Medicare and Medicaid centers have developed a number of schemes that will demonstrate authority allowing certain Medicare rules of payments to determine services offered and how they are paid. It will help to test potential improvements. The already launched initiatives encourage improvement of the quality of care, emphasizing the public reporting on the quality indicators in various health care institutions (Guterman & Serber, 2007).
The health care system stakeholders, specifically the State and Federal governments, nurses associations and other organizations, know about the lack of nursing staff. Thus, they are working towards achieving a lasting solution of the problem (Stanton & Rutherford, 2004). Nursing staff has a significant influence on the safety of patients and quality of health care as well as its cost. While insufficient staffing means heavy workload for the nurses, financial costs are also to be considered. For instance, a study funded by AHRQ shows that the negative effects under study were directly associated with increased costs. Surprisingly, the care costs for patients who developed complications such as pneumonia while in hospital increased by 84 percent.
Quality encompasses a number of nursing care aspects. Over the years, various health care principles have been identified as indicators of quality health care (American Nurses Association, 2000). A number of studies were conducted to evaluate the link between the nurse staffing and care quality (ANA, 1999). The studies determined nursing-sensitive indicators that identify the structure and process of care that, in its turn, influences the quality of care. For instance, one of the structural indicators such as nursing care hours provided per patient was found to have an effect on the quality of health care.