Values and evaluation in health care

The purpose of this paper is to broaden the view of evaluation in health care by 'problemizing' the concepts of quality and evaluation and relating them to a more general discussion of values. The discussion of the concept of quality shows that the concept of quality is often vague or contradictory and that the relationship between quality and costs is problematic. The discussion is broadened by studying quality and evaluation from the viewpoint of four categories of values: scientific values, aesthetic values, ethical values and economic values. The authors also show that values, in addition to constituting the basis for evaluation, actually guide the whole process of care. Values are explicit and implicit elements of the care culture and the individual's action system. The authors conclude that the four value categories could be used to study which values actually guide the care process in real situations.