[Physician-independent quality control of health services]

Currently a physician-independent control of health services can only be managed by means of liability case law. Usually, claims are settled years after the service has been provided, based, though, on medical guidelines that have been established by the medical profession itself at the time of the provision of services. An essential factor in medical quality assurance (QA) is the involvement of the relevant physicians, which should be combined with external controls. Regarding quality in medicine, personal qualification will have to be distinguished from institutional quality and quality of healthcare, which should be ensured by internal and external QA. There is increasing pressure to publish QA results in an institution-related manner. However, the publication of results may lead to the unequal treatment of hospitals, as external QA includes only a limited number of indications (possible misjudgement of overall quality), and refers to different patient populations (no comparable treatment results). However, the publication of such outcome data will prevail in the long-term. The future vision of an external QA system comprises: 1. electronically based patient files and, derived thereof, pseudonymised data sets for QA; 2. IQWiG's participation in the definition of evidence-based indicators for quality assessment as well as the application of these indicators; 3. the full publication of results on an Internet platform.