[Conceptual interpretations of healthcare quality]

The study reviews the development of the concept of healthcare quality starting from its foundations in the second half of the 20th century. Donabedian's landmark publication in 1966 distinguished three dimensions - structure, process, outcome - into which all topics of healthcare quality can be allocated. Donabedian's groundwork expanded into an important field of research both in the United States and Europe. The conceptual foundations were further enriched by the introduction of the health system concept of the World Health Organization, and by the "Health Care Quality Indicators" project launched by the OECD in 2006. The development of quantitative indicators of healthcare quality, primarily those related to outcomes such as burden of disease enabled comparisons between diseases and across countries. The core characteristics of health care quality, showing the strongest relation to the desired outcome ("health") according to the updated concept of the OECD are effectiveness, safety, and patient-centeredness. Hungary did not participate in the OECD project on healthcare quality development, and patient-centeredness has not been included among the characteristics of healthcare quality in the country as opposed to effectiveness and safety. This is a disadvantage in healthcare financed by social insurance not only in terms of relevant indicators not being monitored but also in comparison to private providers of healthcare which are expressly patient-centered. Patient satisfaction monitored by some Hungarian institutions represents only one and not even the most important indicator of the complex concept of patient-centeredness. One of the future challenges for the Hungarian healthcare system is the development and international alignment of the concept of healthcare quality, since any outcome of a healthcare system can only be interpreted in light of the extent to which it ensured subjectively positive experiences for patients. Orv Hetil. 2025; 166(48): 1887-1897.