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Cause-of-death statistics are a major source of information for epidemiological research or policy decisions. Information on the reliability of these statistics is important for interpreting trends in time or differences between populations. Variations in coding the underlying cause of death could hinder the attribution of observed differences to(More)
STUDY OBJECTIVE To analyse international variations of trends in "avoidable" mortality (1980-1997). DESIGN A multilevel model was used to study trends in avoidable and "non-avoidable" mortality and trends by cause of death. SETTING Fifteen countries of the European Union, the Czech Republic, and Hungary. PARTICIPANTS 19 avoidable causes of death among(More)
This review article is about some recent developments in quality assurance in health care. A traditional and a modern approach are distinguished. The traditional approach is marked by a medical perspective and quality is defined as a property of medical care. Development of standards and criteria and inspection of conformance to them is the guiding(More)
During the past three decades, there has been an ongoing debate on the quality of health care. Defining quality is an important part of it. This paper offers a review of definitions and a conceptual analysis in order to understand and explain the differences between them. The analysis results in a semantic rule, expressing the meaning of quality as an(More)
This paper deals with quality assurance in health care and its relation to quality assurance in trade and industry. We present the service quality model--a model of quality from marketing research--and discuss how it can be applied to health care. Traditional quality assurance appears to have serious flaws. It lacks a general theory of the sources of(More)
Revisions of the International Classification of Diseases (ICD) can lead to biases in cause-specific mortality levels and trends. We propose a novel time series approach to bridge ICD coding changes which provides a consistent solution across causes of death. Using a state space model with interventions, we performed time series analysis to(More)
The death of a patient highlights the demand for quality of care. Publication of hospital mortality figures risks incorrect interpretation and does not lead to an improvement in care. However, an above-average hospital mortality rate can be a sign of poor quality in a particular aspect of care. In the necrology meeting, the evaluation of this quality must(More)