Indicators of Quality in Health Care

Abstract

Systems of Quality Assurance are necessary, partly to advance service and professional development, and partly to provide accountability. Such systems require criteria and standards on the basis of which to conduct evaluation, but these are not easy to establish. Not only is there a tension between measurability and relevance, there is also variation in the appropriateness of different criteria between localities and countries. With increasing involvement of external evaluation, and increasing interest in international comparisons, there is concern over the validity of many criteria and standards, and over their inappropriate use. The literature has been reviewed, and a series of consensus meetings held by representatives of eleven European countries. Since criteria and standards are so difficult to agree and vary so widely with different contexts of care, it is necessary first to define and identify indicators of care which are likely to be valid across varying localities and countries. Criteria and standards can then be derived from these indicators.