[Variations in health: a starting point for quality assurance in health care]

Variations in health outcomes may reflect variations in the quality of care. The monitoring of health outcome variations (for example between hospitals or groups of caregivers) may therefore be considered as an instrument for quality assessment in health care. As health care is not the only determinant of health, further research is needed to find out whether health outcome variations are related to variations in the quality of care. Until now, health outcomes have been based mainly on mortality and morbidity measures. In the Netherlands various registries are useful for the monitoring of health outcome variations, such as the cause of death statistics, the national medical registry, the national obstetrics registry and the complications registry of the Netherlands Association of Surgeons.