Improving quality of health care: the role of public health medicine.

In the recent debate on the role of the specialty of public health medicine" the stimulation and support of quality improvement in patient care services have received insufficient attention. The disciplines which underpin the practice of public health, particularly epidemiology, statistics, medical informatics, and the management sciences, are highly relevant to improving health care quality. Public health doctors, who represent one of the disciplines within this broad range of expertise, have a vital and legitimate role in contributing to provider led improvement of quality. The role of the specialty in population health status, health needs, and health care needs assessment has been debated.4 5 In this paper we shall discuss the potential influence of the specialty in assessing and improving the quality of health care provision. To an extent this is a false distinction: a provider may deliver coronary artery bypass grafts of the highest quality, but if this treatment is not accessible to people who would benefit then the quality of care to the community is suboptimal. However, in this article we concentrate primarily on the contribution of public health to the quality of provider care.