Alternative dimensions of quality

The aforementioned six dimensions of health have been widely adapted and adopted, for example by WHO 2006 as part of it is promotion of a health systems approach to improving quality of care. However, it is important to note that there is a large range of dimensions some of which may have greater or lesser relevance in a given situation. Some, such as Godlee 2009, have promoted a simple approach focused on three dimensions of effectiveness, safety and acceptability to the user of the health service as outlined in Figure 2.3.

Godlee's 3 dimensions of quality

Figure 2.3: Godlee’s three dimensions of quality

Source: Godlee, 2009. 

In fact, there are many additional and often overlapping dimensions which are commonly used to describe quality, some of which have been developed into models and frameworks. Figure 2.4 outlines some of the most important, but it is not an exhaustive list:

Figure 2.4: dimensions of quality in healthcare

Element Description
Access to services MNH health services are accessible to people when they need them
Acceptability Conforming to the wishes and expectations of service users/their families
Continuity of care The process by which the patient and the physician are cooperatively involved in ongoing health care management toward the goal of high quality, cost-effective medical care
Effectiveness The degree to which attainable improvements in health are achieved
Efficacy Ability of (interventions) to improve health when used in ‘ideal’ circumstances
Efficiency Ability to lower costs without reducing the effectiveness
Equity Just and fair distribution of health care and its benefits
Interpersonal relations / communications A two-way street where both user and provider are able to speak and are listened to and both are able to fully understand what the other is trying to say.
Legitimacy Conforming to values, norms, law and ethical principles
Optimality Balance of improvements in health to costs
Patient centredness Care that is responsive to users’ needs, values and preferences allowing them power over the decisions that affect them
Performance according to standards Explicit, measurable definitions of how healthcare should be performed.
Physical infrastructure A health centre’s space, design, power, water, hygiene and sanitation and equipment
Safety Doing no harm to the patient
Timeliness Avoidance of unacceptable delay
Reflection: What interplay can you identify between safety and the other key dimensions of quality, for example efficiency?
Alternative dimensions of quality was last modified: June 18th, 2015 by admin