Internationally agreed indicators are providing valuable insights into quality of care.

Health policy makers and managers around the world are striving to secure improvements in the quality of care.

The routine measurement of quality indicators and the subsequent reporting of results has become commonplace in healthcare systems. Recent years have seen a growing interest in moving beyond measuring and reporting within countries or healthcare systems, towards comparing performance across countries.

Although national data can provide a historical account of achievements in quality of care over time, it is often difficult to interpret any changes in performance without comparing externally.

International comparisons provide a yardstick to contextualise the performance of any given healthcare system. For example, national data shows that mortality rates from circulatory disease in England fell markedly between 1993 and 2005. However, international data shows the UK still lagging behind most other developed countries over the same period.

There has recently been increased effort to develop internationally agreed indicators which share definitions and rules for collection. This allows international comparisons such as the Organisation for Economic Co-operation and Development's.healthcare quality indicators project. Such efforts will form the basis for significant learning across participating countries and provide valuable insights into what incentives and institutional arrangements work best to promote good quality healthcare.

Kim Sutherland is co-principal investigator for the 'quest for quality and improved performance', a Health Foundation.initiative.

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