[Medical quality assurance today]

Both the quality and performance of health systems are strongly influenced by the number and the qualification of the professional staff. Quality assurance programs help to analyse causalities which are responsible for medical malpractice. On the basis of the experiences gained by the performance of established Quality Assurance Programs (QAP) in the North Rhine area since 1982 various aspects of the efficiency of these programs will be discussed. The implementation of legal regulations making these programs mandatory is criticised not only for its bureaucratic effect but also for the attempt to exclude professional experts from the interpretation of results. It is recommended to liberalize these regulations in order to facilitate improvement of methods and participation of the medical profession.