[Quality management in oncology]

Quality management (QM) is the intention to achieve an achievable quality of care. QM means collecting, comparing and analysing data, a prerequisite for quality to be translated into quantifiable outcome indicators. In the field of oncology with chronic courses of the disease, longterm results are hard to obtain due to the open channels of cancer care. Longterm results would, however, be required in order to allow comparisons between different physicians and hospitals. If differences do occur, the cause(s) of variation could be identified. How much competition is "healthy" for health (cancer) care? In order to implement QM programs, longterm personal commitment of everybody involved (medical staff and administration) is required. However, it has to be questioned whether all those involved are also prepared. Is the American system of "managed care" the solution to an improved care quality?