BMJ  2007;335:916-918 (3 November), doi:10.1136/bmj.39337.539120.AD

Analysis

Measuring quality through performance

Improving the quality of care with performance indicators

¹ Department of Primary Care and Social Medicine, Imperial College Faculty of Medicine, London W6 8RP, ² National Primary Care Research and Development Centre, University of Manchester, Manchester M13 9PL, ³ Division of General Internal Medicine, University of California San Francisco, San Francisco General Hospital, San Francisco, CA 94110, USA

Effective improvements in health care require methods to evaluate professional practice. Azeem Majeed, Helen Lester, and Andrew Bindman examine the assessment of quality

The first 150 words of the full text of this article appear below.

The quality of services provided by primary care doctors varies widely, and there is often a large gap between optimal primary care services and actual practice.¹ This quality gap can have serious health consequences, including deaths from medical errors, increased rates of complications in chronic disease, hospital admissions for adverse drug reactions and interactions, and outbreaks of potentially preventable infectious diseases such as measles. It also has large financial costs for the healthcare system, national governments, and society, as well as affecting patients' quality of life.

The reasons for the quality gap are not always within the doctors' control. Sometimes the cause can lie with the public—for example, parents who refuse to allow their child to receive the measles, mumps, and rubella vaccine because of concerns about side effects. Even when the doctor and patient agree to follow a healthcare plan that meets the highest standard for quality, structural barriers . . . [Full text of this article]

What is quality and how do we measure it?

Current initiatives

Public disclosure of performance data

What can we learn from other countries?

Web resources
Summary points

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