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Cited by 6,102Healthcare Quality and ManagementPrimary Care and Health OutcomesPatient Satisfaction in Healthcare

Evaluating the quality of medical care

Open access
DONABEDIAN, AVEDIS·2005·The Milbank Quarterly
DOI 10.1111/j.1468-0009.2005.00397.xPMC PMC2690293
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Abstract

This paper is an attempt to describe andevaluate current methods for assessing the quality of medicalcare and to suggest some directions for further study. It is con-cerned with methods rather than findings, and with an evaluation of methodology in general, rather than a detailed critique of methods in specific studies. This is not an exhaustive review of the pertinent literature. Certain key studies, of course, have been included. Other papers have been selected only as illustrative examples. Those omitted are not, for that reason, less worthy of note. This paper deals almost exclusively with the evaluation of the medi-cal care process at the level of physician-patient interaction. It excludes, therefore, processes primarily related to the effective delivery of medi-cal care at the community level. Moreover, this paper is not concerned with the administrative aspects of quality control. Many of the studies reviewed here have arisen out of the urgent need to evaluate and control the quality of care in organized programs of medical care. Nevertheless, these studies will be discussed only in terms of their contribution to methods of assessment and not in terms of their broader social goals. The author has remained, by and large, in the familiar territory of care provided by physicians and has avoided incursions into other types of

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  • The Donabedian structure-process-outcome model provides the primary framework for developing nursing quality indicators.

    “The structure–process–outcome model proposed by Donabedian (13) provides the primary framework for developing nursing quality indicators.”

    From Construction of nursing-sensitive quality indicators for hemodialysis vascular access: a Delphi study (2026) · cites this paper as [13]

    In “Approaches to Assessment: What to Assess,” Donabedian describes structure, process, and outcome as approaches to assessing medical-care quality. “Indices of Medical Care” says quality indices may measure any of the three. The paper does not establish that this model is the primary framework for developing nursing quality indicators specifically. (LLM, conf=0.86)

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1 of the 57 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. [4]4. Lee, R.I., and L.W. Jones. 1933. The Fundamentals of Good Medical Care . Chicago: University of Chicago Press.
  2. [24]24. Daily, E.F., and M.A. Morehead, July, 1956. A Method of Evaluating andImprovingtheQualityofMedicalCare. American Journal of Public Health 46:848-854.
  3. [39]39. Peterson, O.L., and E.M. Barsamian. April, 1964. Diagnostic Performance. In The Diagnostic Process , edited by J.A. Jacquez, 347-362. Ann Arbor: The University of Michigan Press.
  4. [44]44. Peterson, et al., loc. cit., attempted to get some confirmation of weightings through the procedure of factor analysis. The mathematically sophisticated are referred to their footnote on pp. 14-15.
  5. [62]62. Evans, L.R., and J.R. Bybee. February, 1965. Evaluation of Student Skills in Physical Diagnosis. Journal of Medical Education 40:199204.
  6. [69]69. Lusted, L.B., and W.R. Stahl. 1964. Conceptual Models of Diagnosis. In The Diagnostic Process , edited by J.A. Jacquez, 157-174. Ann Arbor: The University of Michigan Press.

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Authors
DONABEDIAN, A.
Corresponding author
DONABEDIAN, AVEDIS
Venue
The Milbank Quarterly
Publisher
Wiley
Published
2005-11-09
Volume
83
Issue
4
Pages
691-729
ISSN
  • 0887-378X (ISSN-L)
  • 1468-0009
DOI
10.1111/j.1468-0009.2005.00397.x
PMC
PMC2690293
OpenAlex
W2119731464
Cited by
6,102
References
57
Citations by year
2026: 217 · 2025: 252 · 2024: 317 · 2023: 282 · 2022: 309 · 2021: 364 · 2020: 276 · 2019: 280 · 2018: 249 · 2017: 243 · 2016: 288 · 2015: 302 · 2014: 288 · 2013: 270 · 2012: 253
FWCI
306.28
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Milbank Quarterly (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
  • Health Sciences › Health Professions › General Health Professions › Primary Care and Health Outcomes
  • Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
Keywords
quality of care, quality assessment methods, physician-patient interaction, health care delivery, medical quality control, evaluation methodology
MeSH terms
Attitude of Health Personnel, Humans, Interpersonal Relations, Personal Satisfaction, Professional-Patient Relations, Quality Assurance, Health Care, Research Design, United States, Quality Indicators, Health Care, History, 20th Century

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