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Defining quality of care


  • Campbell, S. M.
  • Roland, M. O.
  • Buetow, S. A.


This paper defines quality of health care. We suggest that there are two principal dimensions of quality of care for individual patients; access and effectiveness. In essence, do users get the care they need, and is the care effective when they get it? Within effectiveness, we define two key components -- effectiveness of clinical care and effectiveness of inter-personal care. These elements are discussed in terms of the structure of the health care system, processes of care, and outcomes resulting from care. The framework relates quality of care to individual patients and we suggest that quality of care is a concept that is at its most meaningful when applied to the individual user of health care. However, care for individuals must placed in the context of providing health care for populations which introduces additional notions of equity and efficiency. We show how this framework can be of practical value by applying the concepts to a set of quality indicators contained within the UK National Performance Assessment Framework and to a set of widely used indicators in the US (HEDIS). In so doing we emphasise the differences between US and UK measures of quality. Using a conceptual framework to describe the totality of quality of care shows which aspects of care any set of quality indicators actually includes and measures and, and which are not included.

Suggested Citation

  • Campbell, S. M. & Roland, M. O. & Buetow, S. A., 2000. "Defining quality of care," Social Science & Medicine, Elsevier, vol. 51(11), pages 1611-1625, December.
  • Handle: RePEc:eee:socmed:v:51:y:2000:i:11:p:1611-1625

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    Cited by:

    1. Cornelia Prejmerean & Simona Vasilache, 2009. "Study regarding Customer Perception of Healthcare Service Quality in Romanian Clinics, Based on their Profile," The AMFITEATRU ECONOMIC journal, Academy of Economic Studies - Bucharest, Romania, vol. 11(26), pages 298-304, June.
    2. Lappegard, Øystein & Hjortdahl, Per, 2014. "Perceived quality of an alternative to acute hospitalization: An analytical study at a community hospital in Hallingdal, Norway," Social Science & Medicine, Elsevier, vol. 119(C), pages 27-35.
    3. repec:eee:joreco:v:30:y:2016:i:c:p:50-58 is not listed on IDEAS
    4. Cordero Ferrera, Jose Manuel & Alonso Morán, Edurne & Nuño Solís, Roberto & Orueta, Juan F. & Souto Arce, Regina, 2013. "Efficiency assessment of primary care providers: A conditional nonparametric approach," MPRA Paper 51926, University Library of Munich, Germany.
    5. Rosella Levaggi & Michele Moretto & Vincenzo Rebba, 2009. "Investment decisions in hospital technology when physicians are devoted workers," Economics of Innovation and New Technology, Taylor & Francis Journals, vol. 18(5), pages 487-512.
    6. Ahmed, Syed Masud & Hossain, Md. Awlad, 2007. "Knowledge and practice of unqualified and semi-qualified allopathic providers in rural Bangladesh: Implications for the HRH problem," Health Policy, Elsevier, vol. 84(2-3), pages 332-343, December.
    7. Nakaima, April & Sridharan, Sanjeev & Gardner, Bob, 2013. "Towards a performance measurement system for health equity in a local health integration network," Evaluation and Program Planning, Elsevier, vol. 36(1), pages 204-212.
    8. Johnston, Janice M. & Leung, Gabriel & Saing, Hnin & Kwok, Kin-On & Ho, Lai-Ming & Wong, Irene O.L. & Tin, Keith Y.K., 2006. "Non-attendance and effective equity of access at four public specialist outpatient centers in Hong Kong," Social Science & Medicine, Elsevier, vol. 62(10), pages 2551-2564, May.
    9. Hilarion, Pilar & Suol, Rosa & Groene, Oliver & Vallejo, Paula & Herrera, Elisabeth & Saura, Rosa Maria, 2009. "Making performance indicators work: The experience of using consensus indicators for external assessment of health and social services at regional level in Spain," Health Policy, Elsevier, vol. 90(1), pages 94-103, April.
    10. Magnus Lindelow, 2003. "Understanding spatial variation in the utilization of health services: does quality matter?," Economics Series Working Papers WPS/2004-12, University of Oxford, Department of Economics.
    11. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    12. Robin Thompson & Ana Xavier, 2004. "Are Patients in the Transition World Paying Unofficially to Stay Longer in Hospital? Some Evidence from Kazakhstan," LICOS Discussion Papers 14004, LICOS - Centre for Institutions and Economic Performance, KU Leuven.
    13. Fonseca Jaime R. S. & Ramos Rosária M. P. & Santos Ana M. P. & Fonseca Ana P. S. S., 2015. "Policy Effects on the Quality of Public Health Care: Evaluating Portuguese Public Hospitals’ Quality through Customers’ Views," Central European Journal of Public Policy, De Gruyter Open, vol. 9(2), pages 122-131, December.
    14. Valentine, Nicole & Darby, Charles & Bonsel, Gouke J., 2008. "Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries," Social Science & Medicine, Elsevier, vol. 66(9), pages 1939-1950, May.
    15. Shengelia, Bakhuti & Tandon, Ajay & Adams, Orvill B. & Murray, Christopher J.L., 2005. "Access, utilization, quality, and effective coverage: An integrated conceptual framework and measurement strategy," Social Science & Medicine, Elsevier, vol. 61(1), pages 97-109, July.
    16. Liu, Hu-Chen, 2013. "A theoretical framework for holistic hospital management in the Japanese healthcare context," Health Policy, Elsevier, vol. 113(1), pages 160-169.
    17. Olena Kalinichenko & Carla A. F. Amado & Sérgio P. Santos, 2013. "Performance Assessment in Primary Health Care: A Systematic Literature Review," CEFAGE-UE Working Papers 2013_03, University of Evora, CEFAGE-UE (Portugal).
    18. Harteloh, P. P. M., 2003. "Quality systems in health care: a sociotechnical approach," Health Policy, Elsevier, vol. 64(3), pages 391-398, June.
    19. Van Herck, Pieter & Annemans, Lieven & De Smedt, Delphine & Remmen, Roy & Sermeus, Walter, 2011. "Pay-for-performance step-by-step: Introduction to the MIMIQ model," Health Policy, Elsevier, vol. 102(1), pages 8-17, September.
    20. Magnus Lindelow, 2004. "Understanding spatial variation in the utilization of health," Development and Comp Systems 0409058, EconWPA.
    21. Perera, Roshan & Dowell, Tony & Crampton, Peter & Kearns, Robin, 2007. "Panning for gold: An evidence-based tool for assessment of performance indicators in primary health care," Health Policy, Elsevier, vol. 80(2), pages 314-327, February.
    22. Kruk, Margaret Elizabeth & Freedman, Lynn P., 2008. "Assessing health system performance in developing countries: A review of the literature," Health Policy, Elsevier, vol. 85(3), pages 263-276, March.
    23. Ashill, Nicholas J. & Rod, Michel, 2011. "Burnout processes in non-clinical health service encounters," Journal of Business Research, Elsevier, vol. 64(10), pages 1116-1127, October.
    24. van der Geer, Eric & van Tuijl, Harrie F.J.M. & Rutte, Christel G., 2009. "Performance management in healthcare: Performance indicator development, task uncertainty, and types of performance indicators," Social Science & Medicine, Elsevier, vol. 69(10), pages 1523-1530, November.

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