Quality in primary health care: a multidimensional approach to complexity

HEATH, I; RUBINSTEIN, A; STANGE, K; VAN DRIEL, M

BRITISH MEDICAL JOURNAL

B M J PUBLISHING GROUP

Lugar: Londres; Año: 2009 p. 1 - 30

0959-535X

Good care is much more than meeting disease specific targets. Iona Heath and colleagues argue that assessments of quality must take into account all the complexities of primary health care In his 1913 novel Chance, Joseph Conrad wrote about the changing fashion for certain words: ?You know the power of words. We pass through periods dominated by this or that word?it may be development, or it may be competition, or education, or purity or efficiency or even sanctity. It is the word of the time.? Today?s word is quality. In order to assess the quality of primary health care, we have to define what quality means in this context. But who should make the definition, and whose perspective should take priority? The easy assumption is that quality should be defined by patients rather than by policymakers, politicians, or healthcare professionals?but who is the representative patient? How generalisable can any measure of the quality of primary health care be across different economic, social, and cultural contexts?