Evaluating the Quality of Health Care

2. Introduction

Almost everyone would say that they want high quality health care and most people have an intuitive sense of what that means. When one wants to develop a research project related to quality of care, however, one quickly finds what is true in many areas of research; that it is much easier to have a sense of what quality is than it is to develop an operational definition and valid and reliable measures of quality.

Part of this complexity in defining quality of care is that different groups can have very different reasons for measuring quality and hence different measurement criteria and emphases.

For example:

  • Clinicians or those who manage and provide clinical care might be interested in evaluating quality so that they can monitor and improve the services they are providing to individual patients.
  • Regulators may be interested in ensuring that care provided by a health care organization (e.g. health plan or hospital) meets a minimal standard and/or is making credible efforts to improve care quality.
  • Consumers and other purchasers may be most interested in information that they can use to select clinicians or health care organizations.

Although all of these parties might agree on a definition of high quality care they might select different measures and researchers studying these different areas might have similar variations in emphases.