[Concept of indicators: central element of quality management].
BACKGROUND
Explicit data on the quality of health care in addition to economic data represent major instruments of internal as well as external controlling and resource allocation.


METHODS
Indicators are selected parameters, which are able to monitor health care in regard to particular features and (adverse) events. They have to be evaluated for their feasibility, reliability and validity. Indicators are expected to play a central role in external quality assurance in Germany, and are a key issue in recent health legislation. Combinations of indicators lead to indicator systems, which have to undergo validation as well. The "Kooperation für Transparenz und Qualität" (KTQ) which is now extensively used in Germany, is an example for an indicator-based accreditation system.


CONCLUSIONS
Issues of further discussion are loss of validity of indicators due to awareness and alteration of documentation habits, public disclosure, and the evaluation of indicators by means of evidence-based medicine.
Schrappe
M
M
Zentrale Dienstleistungseinrichtung für Qualitätsmanagement des Klinikums, Universität Köln. Matthias.Schrappe@medizin.uni-koeln.de
D005858:Germany; D006801:Humans; D017146:Models, Organizational; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*