How can the quality and performance of healthcare providers best be measured in conflict settings where access is limited, such as in Syria?
The purpose of the review was to provide a summary of possible indicators which might be used to measure the performance and quality of healthcare in conflict-affected settings. There is considerable guidance on measuring access, availability and quantity of health provision in these settings, but much less on whether this care is sufficient or effective. This review identifies and summarises some indicators which have been used or are suggested as appropriate.
Quality of care in humanitarian contexts is under-studied. It is both difficult to define and difficult to measure. In general, all indicators used should be SMART: Specific (what and who); Measurable; Appropriate; Realistic (achievable); Time bound. And should be grouped under structural, process and outcome domains.
The most agreed-on predictors of quality of care are:
- Number of outpatient consultations per person per year
- Number of consultations per clinician per day
- Time spent on patient consultation and counselling
- Case Fatality Ratio for the most common diseases (a direct measurement of the efficacy of treatment)