An overview of quality issues in health services.

This paper establishes a common framework for understanding some of the quality issues in health services. It presents definitions and examples of the most frequently used and the most frequently confused terms related to quality. The meanings of quality, quality of health care, quality assessment, quality assurance, quality control and total quality management are described with illustrative examples. The major approaches to quality assessment and its uses are discussed. A model of the quality assurance process is explained as well as the issues surrounding quality assurance in the settings of primary and secondary health services.