Which of the following is attributed to the rising cost of healthcare?

A. Hospital downsizing in the United States: Hospital downsizing generally aims to reduce costs and improve efficiency, not increase healthcare costs.

B. Transition from primarily government institutions to community institutions: This transition often seeks to improve accessibility and cost-effectiveness in healthcare delivery rather than causing rising costs.

C. Advanced sanitation, nursing, and medical services: While these contribute to better health outcomes and possibly higher initial investments, they are not the primary driver of rising healthcare costs.

D. Third-party payment: Third-party payment systems, such as insurance companies, contribute

to rising healthcare costs due to factors like administrative expenses, profit margins, and complex billing processes.

Rationale:

A. Promotes the use of performance measurements in health care: This answer describes the purpose of quality indicators in general but does not specifically address the macro perspective.

B. Focus on individual services at the point of delivery: This describes the micro perspective, which focuses on specific aspects of care delivery.

C. Reflect the performance of the entire health care delivery system: The macro perspective of quality indicators looks at the overall performance of the entire healthcare system, including factors such as access, effectiveness, and efficiency.

D. Look at the performance of an individual or organization: While this may be a component of quality measurement, it does not encompass the broader view of the macro perspective.