Managing quality in primary health care: the need for valid information about performance

Information about the quality of care is essential if quality is to be managed effectively, but information is difficult to come by in primary care. Systems for providing primary health care services vary from country to country. Depending on the country, the providers of care may be general practitioners, family physicians, specialists working in the community, or nurses. They may work in solo practices or in large, multi-professional groups or even teams, and may or may not be integrated with social and community services. They may or may not have a gatekeeper function to secondary care, and methods of funding primary health care vary from payment by the patient alone to payment by the state alone, with all manner of combinations between these extremes. It could be argued that the defining characteristic of national health care systems is the method of providing primary health care.

After years of neglect, governments and funding agencies in many countries have become interested in the potential of primary health care to …