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As the health‐care industry undergoes major change, a method of “accounting for quality” has become a key factor in health services delivery and fiscal accountability. This article examines several aspects of health care that inhibit the development of common methods of defining and accounting for quality. Key issues and characteristics of the health‐care market are addressed and the article provides a synthesis of these obstacles to the process of deriving common measures and standards of quality that may be utilized by the health‐care industry for financial decisions.

To develop a framework for evaluating the quality of Portuguese health care organisations based on the relationship between customers and providers, to define key variables related to the quality of health care services based on a review of the available literature, and to establish a conceptual framework in order to test the framework and variables empirically.

Systematic review of the literature.

Health care services quality should not be evaluated exclusively by customers. Given the complexity, ambiguity and heterogeneity of health care services, the authors develop a framework for health care evaluation based on the relationship between customers (patients, their relatives and citizens) and providers (managers, doctors, other technical staff and non‐technical staff), and considering four quality items (customer service orientation, financial performance, logistical functionality and level of staff competence).

This article identifies important changes in the Portuguese health care industry, such as the ownership of health care providers. At the same time, customers are changing their attitudes towards health care, becoming much more concerned and demanding of health services. These changes are forcing Portuguese private and public health care organisations to develop more marketing‐oriented services. This article recognises the importance of quality evaluation of health care services as a means of increasing customer satisfaction and organisational efficiency, and develops a framework for health care evaluation based on the relationship between customers and providers.

Explores the theoretical context of quality and quality assurance in health care through a detailed review of the current literature. Outlines the definitions of quality and quality assurance. Identifies the two structural elements of quality assurance: quality assessment and quality improvement and control. Explores in some detail the elements of health care which are capable of assessment and the relationships between them. Finally, considers the mechanisms which can be used to improve health care if deficiencies are highlighted.

This study examined the effectiveness of using the Internet to teach consumers about quality health care, compared consumer definitions of quality health care prior to and following completion of the Internet experience, and compared ratings of learning, satisfaction and value of the Internet instruction between consumers who completed the Internet intervention alone and consumers who completed the Internet intervention and interacted with a nurse. A total of 34 people from a community library participated in this randomized comparative study. The intervention was effective in increasing consumer knowledge of quality care from pre‐ to post‐test. Although there were no significant differences between the two groups in knowledge gain, consumers in the interaction group had significantly higher scores on usefulness of the information in assessing the quality of care they are receiving from their health‐care providers.

The development of managed care plans is the most dramatic change in the USA’s health care system in recent decades. Despite the widespread growth, society is increasingly concerned with the quality of managed care programs. This article addresses the regulatory pressures that are being placed on managed care organisations, and examines what health care practitioners can do to minimize the impact of increased regulation. We look at the major factors that are likely to bring about changes in the health care sector, and predict how these changes will affect the quality of health care that is being delivered in the near future. Addresses how quality can become and remain the primary factor in the delivery of health care services. Finally, concludes that greater involvement by the federal government is necessary to protect consumers’ rights, and ensure better quality health care from managed care programs.

The effective management of health services and the delivery of quality systems in Irish health‐care institutions have increased in significance in recent years. Consumers (patients) are expecting more of health‐care providers and are demanding higher standards of care and service. Simultaneously, those paying for health services have become more concerned about rising health costs and possible inefficiencies. As a result there is widespread interest in understanding what makes for an effective health service and in developing better practices to improve existing approaches to health‐care management and delivery. Reviews developments in quality‐service management in the Irish health‐care sector and focuses attention on the need for the development of a model for quality implementation in health‐care institutions.

This paper aims to examine the major factors affecting patients’ satisfaction and loyalty at a health-care organization in India.

A conceptual model has been developed that includes the behavioural dimensions of total quality management (TQM), patient satisfaction and loyalty. This study is exploratory in nature and has used the existing literature to build the conceptual model.

A solution for improving the quality of health-care services can be found in the application of total relationship management and TQM, together with a customer orientation strategy.

The results can be used creatively by hospitals to re-engineer and redesign their quality management processes and reorient the future directions of their more effective health-care quality strategies.

In this research, a study is described involving a new instrument and a new method which assure a reasonable level of relevance, validity and reliability, while being explicitly change-oriented.

Claiming that quality assurance in Europe is a growth industry, the paper looks at this development from three angles: Has quality assurance become a science? Is it being practised? And how can quality assurance be successfully introduced? The paper concludes that quality assurance cannot yet be considered ‐ nor does it need to become ‐ a science, meeting the usual criteria of a scientific discipline. In spite of this, quality assurance has to be based on sound scientific evidence. There are encouraging signs of this happening: while there is no long research tradition in quality assurance, the number of studies is increasing and their quality is improving. On positive action, the paper finds the situation brighter. There is both political will and professional acceptance. WHO's European member states have accepted as a part of their overall health for all policy a specific target which requests them to build effective mechanisms for ensuring quality of patient care. The increasing professional interest and political will have resulted, among other things, in laws, quality assurance programmes, training programmes, national societies and journals. Views on quality and quality assurance have broadened; consumer views are being accepted as part of quality; the outcomes of care are emphasised; quality assurance is being extended from hospitals to primary care and nursing homes, and from medical care to nursing care and physiotherapy. Based on lessons learned from the past experiences, the last section of the paper makes recommendations for the successful introduction of quality assurance. The importance of demonstrating a need, the involvement of all those concerned and the provision of feedback are emphasised.

The purpose of this study is to understand that how different demographic variables and repeated availing of service from the same doctor or same hospital shape the overall perception of health-care service quality and satisfaction among inpatients admitted in private hospitals in an emerging economy.

A self-administered, cross-sectional survey of inpatients using a questionnaire was translated into Hindi and Gujarati. The data were collected from 702 inpatients from 18 private clinics located in three selected cities from Western India.

The results indicate that experience with hospital administration, doctors, nursing staff, physical environment, hospital pharmacy and physical environment is significant predictor of inpatient satisfaction. Physical environment was found to be significantly associated with satisfaction only among female inpatient. It was also found that repeat availing of services either from the same hospital or doctor does not increase patient satisfaction. The feasibility, reliability and validity of the instrument that measures major technical and nontechnical dimensions of quality of health-care services were established in the context of a developing country.

The study makes important contribution by empirically investigating the inpatient assessment of health-care service quality based upon their demographic information and repeated availing of services to understand how repeat visit shapes the service quality perception.

This study aims to explore the influence of health-care service quality on customers’ perceived value, satisfaction, effectiveness and behavioural intention concerning district health centres (DHCs) in Hong Kong. This research also intends to assess customers’ perception of the subsidy scheme and its influence on the relationships amongst the aforementioned constructs.

The convenience and snowball sampling approaches were adopted, and the self-administered questionnaire was sent to 309 customers of DHCs.

Service quality attributes in terms of staffing and procedures positively increased customers’ perceived value and staffing, procedures and operations. Physical facilities positively promoted customers’ satisfaction, consequently improving DHCs’ effectiveness and behavioural intention. However, core treatments and services of DHCs did not impact customers’ perceived value and satisfaction. Furthermore, customers receiving subsidies exhibited a more positive perception than those without subsidies.

Health-care organisations are advised to strategically allocate resources (staffing, facilities and procedures and operations management) to optimise overall performance outcomes. DHC operators could reinforce the core services of DHCs and health-care voucher subsidies to local citizens so as to enhance the effectiveness of DHCs and behavioural intention of customers.

This study integrates the input–process–output approach in measuring the effectiveness of and customers’ behavioural intention towards newly established DHCs.