The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Understanding and measuring quality of care: dealing with complexity
Open accessAbstract
Existing definitions and measurement approaches of quality of health care often fail to address the complexities involved in understanding quality of care. It is perceptions of quality, rather than clinical indicators of quality, that drive service utilization and are essential to increasing demand. Here we reflect on the nature of quality, how perceptions of quality influence health systems and what such perceptions indicate about measurement of quality within health systems. We discuss six specific challenges related to the conceptualization and measurement of the quality of care: perceived quality as a driver of service utilization; quality as a concept shaped over time through experience; responsiveness as a key attribute of quality; the role of management and other so-called upstream factors; quality as a social construct co-produced by families, individuals, networks and providers; and the implications of our observations for measurement. Within the communities and societies where care is provided, quality of care cannot be understood outside social norms, relationships, trust and values. We need to improve not only technical quality but also acceptability, responsiveness and levels of patient-provider trust. Measurement approaches need to be reconsidered. An improved understanding of all the attributes of quality in health systems and their interrelationships could support the expansion of access to essential health interventions.
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Cites
Crossing the Quality Chasm: A New Health System for the 21st Century
Committee on Quality of Health Care in America (2002) · Journal For Healthcare Quality · doi:10.1111/j.1945-1474.2002.tb00463.x · Cited by 8,483
Donabedian, A. (1988) · JAMA · doi:10.1001/jama.260.12.1743 · Cited by 5,895
UNCERTAINTY AND THE WELFARE ECONOMICS OF MEDICAL CARE
Arrow, K. J. (2003) · Uncertain Times · doi:10.2307/j.ctv11sn34h.6 · Cited by 4,078
The world health report 2000 - Health systems: improving performance
Reinhardt, U. E., & Cheng, T.-M. (2000) · Europe PMC (PubMed Central) · doi:10.1590/s0042-96862000000800020 · Cited by 3,467
What works? Interventions for maternal and child undernutrition and survival
Bhutta, Z. A., Ahmed, T., Black, R. E., Cousens, S., Dewey, K., Giugliani, E., Haider, B. A., Kirkwood, B., Morris, S. S., Sachdev, H., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(07)61693-6 · Cited by 2,258
Disease control priorities in developing countries
Frenk, J. (2006) · Salud Pública de México · doi:10.1590/s0036-36342006000600011 · Cited by 1,599
Overcoming barriers to health service access: influencing the demand side
Ensor, T. (2004) · Health Policy and Planning · doi:10.1093/heapol/czh009 · Cited by 898
Rationality of Self and Others in an Economic System
Arrow, K. J. (1986) · The Journal of Business · doi:10.1086/296376 · Cited by 552
Das, J., Holla, A., Das, V., Mohanan, M., Tabak, D., & Chan, B. (2012) · Health Affairs · doi:10.1377/hlthaff.2011.1356 · Cited by 424
The Quality of Medical Advice in Low-Income Countries
Das, J., Hammer, J., & Leonard, K. (2008) · Journal of Economic Perspectives · doi:10.1257/jep.22.2.93 · Cited by 390
Cited by
Towards an understanding of resilience: responding to health systems shocks
Hanefeld, J., Mayhew, S., Legido-Quigley, H., Martineau, F., Karanikolos, M., Blanchet, K., Liverani, M., Yei Mokuwa, E., McKay, G., & Balabanova, D. (2018) · Health Policy and Planning · doi:10.1093/heapol/czx183 · Cited by 282
Self-citationZhang, W., Cheng, B., Zhu, W., Huang, X., & Shen, C. (2021) · Telemedicine and e-Health · doi:10.1089/tmj.2020.0122 · Cited by 55
Talking about quality: how ‘quality’ is conceptualized in nursing homes and homecare
Aase, I., Ree, E., Johannessen, T., Strømme, T., Ullebust, B., Holen-Rabbersvik, E., Thomsen, L. H., Schibevaag, L., van de Bovenkamp, H., & Wiig, S. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06104-0 · Cited by 47
Graham, H. R., Maher, J., Bakare, A. A., Nguyen, C. D., Ayede, A. I., Oyewole, O. B., Gray, A., Izadnegahdar, R., Duke, T., & Falade, A. G. (2021) · PLOS ONE · doi:10.1371/journal.pone.0254229 · Cited by 8
Metadata
- Authors
- Hanefeld, J., Powell-Jackson, T., & Balabanova, D.
- Venue
- Bulletin of the World Health Organization
- Publisher
- WHO Press
- Published
- 2017-03-20
- Volume
- 95
- Issue
- 5
- Pages
- 368-374
- ISSN
- 0042-9686 (ISSN-L)
- OpenAlex
- W2607515139
- Cited by
- 351
- References
- 38
- FWCI
- 33.49
- Type
- journal article
- Language
- en
- Open access
- diamond
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Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
