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Measuring quality: from the system to the provider.

D B Evans1, T T Edejer, J Lauer

  • 1Evidence and Information for Policy, World Health Organization, Geneva, Switzerland. evansd@who.int

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
|January 5, 2002
PubMed
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This study proposes a new framework for measuring health system quality using desired outcomes, not just processes. This outcome-focused approach helps policymakers ensure systems achieve goals, though challenges in measurement and attribution exist.

Area of Science:

  • Health Services Research
  • Public Health Policy
  • Healthcare Quality Improvement

Background:

  • Traditional quality assessment in healthcare literature often relies on process indicators.
  • There is a need for a framework that evaluates health system quality based on measurable outcomes.

Purpose of the Study:

  • To outline a framework for describing and measuring health system quality using desirable outcomes.
  • To illustrate the application of this framework using World Health Organization (WHO) data.
  • To explore the framework's applicability across various health system components (regions, districts, hospitals, providers).

Main Methods:

  • Development of a framework focusing on health system outcomes.
  • Utilizing data from a World Health Organization (WHO) health system performance evaluation.

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  • Analysis of the framework's utility and challenges for different system levels.

    • Main Results:

    • A framework for health system quality measurement based on outcomes is presented.
    • The framework's potential application across diverse health system levels is explored.
    • Advantages include policy focus on goals; disadvantages involve measurement challenges (sample size, attribution, timing).

    Conclusions:

    • Measuring health system quality by outcomes offers a goal-oriented perspective for policymakers.
    • Outcome measurement is crucial for verifying the impact of process improvements.
    • Challenges in attribution and timing require further investigation, particularly for hospital-level quality assessment.