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Manuscript Title

How to Find the Right Approach to Quality Measurement: Determinants of Quality and Its Measurement in Healthcare

Abstract

Measuring quality in health care is an important as well as frequent issue for polic makers and other parties. However, many attempts to measure quality fail. This paper analyzes typical reasons for failures and derives a set of determinants whose application decides on measurement success: the disease studied, the type of treatment studied, definition of "outcome," purpose of quality measurement, time and location of treatment, measurement technique, and expected reasons for and amounts of quality differences. By discussing determinants in detail, a list of questions that should be answered before starting quality measurement is developed. Because determinants are equally important for investigators and policy makers, issues specific to the latter are discussed in an additional paragraph.