External quality assurance in Germany - the state of the art

Background: The so-called "external quality assurance" allows the comparison of hospitals using selected quality indicators for process and outcome of care. The methods were developed in early projects of perinatologoists and surgeons in the mid 70s. The comparative statistics inform hospitals about their strengths and deficiencies compared to other hospitals. State of the Art: Since 2001 the Federal Committee on Quality Assurance (Bundeskuratorium Qualitdtssicherung) requests the realization of external quality assurance measures for 27 diseases and procedures in all German hospitals based on the 5th Social Law. If hospitals refuse participation or participate incompletely, they have to expect financial sanctions. The comparative statistics enable first assessments of the quality of hospital care. However, the methods have to be improved if they will be used to demonstrate quality of hospital care to people outside the hospitals.