P4P.  Evidence-based medicine.  Insurers and policymakers want to be sure that patient insurance premiums are being used towards high quality medical care.

One example of quality evaluation in practice is the Apgar Score.  In 1952, Dr. Virginia Apgar developed this metric to evaluate the health of newborns.  Newborns receive a 0, 1, or 2 score on 5 different metrics.  Thus, the total score ranges from 0 to 10.  The test is administered at one minute and five minutes after birth, and sometimes also at 10 minutes.

You can see how the Apgar score is actually calculated here.


  1. The APGAR score is a poor predictor of neonatal death and long-term neurologic function. It simply indicates the progress of neonatal resuscitative efforts.

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