![]() How can quality be measured? From a concept of quality to quality indicators Overviews of measurement challenges related to international comparisons are provided by Forde, Morgan & Klazinga ( 2013) and Papanicolas & Smith ( 2013).ģ.2. An overview of the history of quality measurement (with a focus on the United States) is given in Marjoua & Bozic ( 2012). ![]() The chapter also provides examples of quality measurement systems in place in different countries. Other dimensions of health system performance, such as accessibility and efficiency, are not covered in this chapter as they are the focus of other volumes about health system performance assessment ( see, for example, Smith et al., 2009 Papanicolas & Smith, 2013 Cylus, Papanicolas & Smith, 2016). on the quality dimensions of effectiveness, patient safety and patient-centredness. In line with the focus of this book ( see Chapter 1), the chapter focuses on measuring quality of healthcare services, i.e. This chapter presents different approaches, frameworks and data sources used in quality measurement as well as methodological challenges, such as risk-adjustment, that need to be considered when making inferences about quality measures. Common to all strategies in Part II is that without robust measurement of quality, it is impossible to determine the extent to which new regulations or quality improvement interventions actually work and improve quality as expected, or if there are also adverse effects related to these changes. In particular, accreditation and certification ( see Chapter 8), audit and feedback ( see Chapter 10), public reporting ( see Chapter 13) and pay for quality ( see Chapter 14) rely heavily on the availability of reliable information about the quality of care provided by different providers and/or professionals. Measuring quality of care is important for a range of different stakeholders within healthcare systems, and it builds the basis for numerous quality assurance and improvement strategies discussed in Part II of this book. ![]() National policy-makers recognize that without measurement it is difficult to assure high quality of service provision in a country, as it is impossible to identify good and bad providers or good and bad practitioners without reliable information about quality of care. The increasing interest in quality measurement has been accompanied and supported by the growing ability to measure and analyse quality of care, driven, amongst others, by significant changes in information technology and associated advances in measurement methodology. Furthermore, a growing focus on value-based healthcare (Porter, 2010) has sparked renewed interest in the standardization of measurement of outcomes (ICHOM, 2019), and notably the measurement of patient-reported outcomes has gained momentum (OECD, 2019). The Organisation for Economic Co-operation and Development (OECD) and the EU Commission have both expanded their efforts at assessing and comparing healthcare quality internationally (Carinci et al., 2015 EC, 2016). At the same time, international efforts in comparing and benchmarking quality of care across countries are mounting. Quality of care is now systematically reported as part of overall health system performance reports in many countries, including Australia, Belgium, Canada, Italy, Mexico, Spain, the Netherlands, and most Nordic countries. Researchers and policy-makers are increasingly seeking to develop more systematic ways of measuring and benchmarking quality of care of different providers. The field of quality measurement in healthcare has developed considerably in the past few decades and has attracted growing interest among researchers, policy-makers and the general public (Papanicolas & Smith, 2013 EC, 2016 OECD, 2019).
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