Abstract
In many European countries, governments, third-party payers, patient and consumer organisations and healthcare professionals monitor the quality of health care by means of indicators. On the national and international level, policymakers see indicators as an essential tool to keep track of trends and evaluate the impact of policies. Third-party payers are interested in quality indicators to measure their ‘return-on-investment’, to implement pay-for-performance schemes or selective contracting. For patients, quality indicators are an important source of consumer information to facilitate choice. And finally, professionals use quality indicators to continuously monitor and improve their performance. The development of indicators ideally takes place in interaction between researchers and stakeholders.1 In this interactive process, the international scientific literature serves as input for indicator development. However, indicators that have been developed and tested in a certain setting or country need to be adapted to the local context and the specific objective for which they are applied. Adaption to the local context is necessary for several reasons. One is that the information infrastructure that …
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