Advantages and limitations of explicit criteria for assessing the quality of health care

Abstract

Explicit criteria for assessing the quality of health care should appeal to practitioners because such criteria make possible consistent judgments, openly arrived at. The process of their formulation encourages more critical scrutiny of current practice, identifying what the generality of practitioners can accept, and what is still doubtful. But, as instruments of social control, explicit criteria are a two-edged sword-vehicles for the best that medicine can offer, or instruments of institutionalized and pervasive error. Therefore, it is important to see who controls the criteria, whose perspectives and interests they serve, and what images of quality they render at once concrete and dominant.