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Qual Manag Health Care. 2002 Summer;10(4):41-52.

An evidence-based evaluation of quality and efficiency indicators.

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Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.


The goal of this study was to identify and appraise quality and efficiency indicators relevant to hospitals or physicians' practices by performing a systematic literature search. Process indicators were limited to 11 diagnoses and treatments. To appraise the indicators identified, a framework for grading health care recommendations was expanded to categorize evidence on cost-effectiveness. Seven indicators of structural quality and 34 indicators of process quality were identified and appraised. The set of performance indicators could serve as a state-of-the-art system of measurement for governments and organizations evaluating the quality and efficiency of health care.

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