ABSTRACT
The values underpinning any system should be clearly visible within the key policy documents governing the healthcare system in any country. D. Garvin proposed a multi-perspective model of quality, based upon five 'views'. These are: the transcendent view; the product-based view; the user-based view; the manufacturing view; and the value-based view. The product-based view is the economist's view: the higher the quality, the higher the cost. The basis for this view is that it costs money to provide higher quality. The user-based view was championed in the 1940s, and is traditionally expressed as fitness for purpose. It is sometimes represented as patient satisfaction. The manufacturer's view measures quality in terms of conformance to requirements. The manufacturing view emerges in healthcare in a number of ways. In a business context, the value-based view is the ability to provide what the customer requires at a price they can afford. A value-based view of quality assesses the cost-effectiveness of a service or treatment.
