ABSTRACT
This chapter reviews both the potential and the limitations of quality/performance indicators, with illustrative examples from primary and secondary care. It provides that a checklist of questions to ask when the use of indicators is being considered. Indicators of performance aim to improve the quality of health services, ultimately resulting in improved patient care and population health. The health authority identified a range of primary care outcome measures, chosen on the basis of relevance to health, patient-centredness, application to broad populations, and allowing comparison between providers. The commonest classification uses the Donabedian triad of structure, process and outcome, to which can be added access indicators and activity indicators. The use of indicators is highly dependent on the quality of the underlying data source - data should be both complete and accurate. An indicator reflecting clinical practice should be sensitive to change. Indicator-based judgements may create perverse incentives. Participants will seek to do well on the chosen indicators.
