Some commonforces have led to increased attention to quality assurance andprogram evaluation in the United States. However, these two types of public accountability have developed relatively independently, resulting in somewhat different but related approaches to examining health care. The similarities and differences between qualityof-care assurance and program evaluation are discussed as related to their definitions and approaches to data collection and utilization. Pressures to integrate quality assurance and program evaluation and evidence of a convergence in the two types of assessment activities are also presented. The article concludes with a discussion of thefuture role of the states and localities in assuming responsibilityfor these two types of accountability.
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