Table 2 Dimensions and outcome categories based on the Donabedian model for quality of care
From: Impact of reimbursement systems on patient care – a systematic review of systematic reviews
Dimension | Donabedian framework | Category | Exemplary content |
|---|---|---|---|
Structure | Physical and organizational characteristics where healthcare occurs | Unintended consequences | Risk selection, spill-over effects |
Organizational changes | Effects on personnel structure | ||
Process | Focus on the care delivered to patients e.g. services, diagnostics or treatments | Resource utilization | Readmission rates, length of stay |
Access | Socioeconomic inequalities in the utilization of health care services | ||
Behavior | Intrinsic motivation, documentation | ||
Outcome | Effect of healthcare on the status of patients and populations | Quality/Health outcomes | Mortality, treatment quality |
Efficiency | Effects on direct savings for medical services | ||
Economic effects | Effects on total social expenditures |