Dimensions and Indicators of Quality of Health Care Used for Healthcare Systems’ Performance Assessment

Abstract

Delivering high-quality health care is a central goal of all healthcare systems. Quality of health care is one of the basic components used for health system performance assessment (HSPA). Quality of health care is measured by six dimensions – effectiveness, safety, patient-centeredness, access, appropriateness, and continuity of care. This study aims to identify and systematize the most frequently used dimensions and indicators for measuring the quality of health care used for health system performance assessment. To achieve this aim the review is implemented on the base of HSPA reports from various countries and organizations as well as scientific publications related to quality of health care. Founded on the review of conceptual HSPA frameworks are identified 304 different indicators for measuring quality of health care. Most of them are focused on measuring process and outcome of health care. Effectiveness, safety and patient centeredness are the elements consist of the most used dimensions for measuring quality of health care. Certain differences in understanding of the essence of quality of health care dimensions and indicators were identified in the reports. They could be explained by the diversity of concepts of quality of health care, of health insurance models and of health care system goals in different countries. Measuring quality of health care is a key significance in health care system performance assessment. It provides important information about areas and components of the health care system which need of improvement as a basis for consequential policy and political decisions.