[The past and present history of the term "quality" in medicine]

In the medieval hospital the terms "care" and "cure" constituted a kind of hendiadys; in the XVIII century the quality of services was precisely identified for the first time, and, between the XVIII and the XIX centuries, medicine also began to assess the quality of professional competence, recognizing the need for a fair allocation of resources, and directing the health services only towards those who really needed them. In the XIX century the "Regolamenti" of hospital institutions are made compulsory in Italy, as foreseen by the Public Health Law of 1888. However, only during the XX century, and particularly in the second half of the century, quality standards are defined, together with the structuring of a health service and with the ever more widely felt need for a new relationship between the physician and the patient, and between the patient and the institution. In even more recent times, during the 1990s, Evidence Based Medicine has given a further stimulus to every currently interpreted quality systems.