Quality health care is a human right and not a privilege

13Apr 2020
The Guardian
Quality health care is a human right and not a privilege

Healthcare quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose.

The goal of healthcare is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine healthcare quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.

Healthcare quality is the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes. Quality of care plays an important role in describing the iron triangle of health care, which defines the intricate relationships between quality, cost, and accessibility of health care within a community. Researchers measure health care quality to identify problems caused by overuse, underuse, or misuse of health resources.

While essential for determining the effect of health services research interventions, measuring quality of care poses some challenges due to the limited number of outcomes that are measurable. Structural measures describe the providers' ability to provide high quality care, process measures describe the actions taken to maintain or improve community health, and outcome measures describe the impact of a health care intervention. Furthermore, due to strict regulations placed on health services research, data sources are not always complete.

Assessment of health care quality may occur on two different levels: that of the individual patient and that of populations. At the level of the individual patient, or micro-level, assessment focuses on services at the point of delivery and its subsequent effects. At the population level, or macro-level, assessments of health care quality include indicators such as life expectancy, infant mortality rates, incidence, and prevalence of certain health conditions.

Quality assessments measure these indicators against an established standard. The measures can be difficult to define in health care. Quality assurance is distinct from quality assessment and is based on the principles of total quality management (TQM). It is a method of using quality assessment measures in a system-wide manner to deliver high-quality care that is continually improving.

The multi-layered crisis of the coronavirus epidemic has been a dramatic shock to everyone. But, to communities affected by HIV and AIDS, the crisis has not only brought a further shock to already vulnerable people, it has brought other reactions too - a troubling sense of déjà vu, and a passionate, empathetic, fierce solidarity with all those affected by Coronavirus.

No two pandemics are the same. All require a specific, tailored, response. But we also have a duty, when dangerous, unjust and unsustainable structural weaknesses are exposed by one pandemic, left unresolved, and then jeopardize the fight against a second pandemic, to ensure that we don't wait for the third.

Everyone involved in the fight against AIDS is determined to do everything we can to support all those affected by the coronavirus epidemic. We waited years for many of the breakthroughs we fought for, and we are still waiting for many others; we refuse to let leaders make us wait in this new crisis as they have made us wait. The time to fix the rips in our social fabric is now.

The HIV community has joined the emergency response in solidarity with those affected, and has joined too in insisting that leaders recognize that healthcare is a public good - that the health of each of us depends on the health of all of us.

Healthcare must be provided to all, free of charge, funded by public revenue. Quality health care is a human right, not a privilege, and should never depend on how much money you have in your pocket.