PubMed · 9728736
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W Burkart. 1998. Forcing a link?. https://doi.org/10.1007/s004110050095
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BACKGROUND: Explicit data on the quality of health care in addition to economic data represent major instruments of internal as well as external controlling and resource allocation. INDICATORS: Indicators are selected parameters, which are able to monitor health care in regard to particular features and (adverse) events. They have to be evaluated for their feasibility, reliability and validity. Indicators are expected to play a central role in external quality assurance in Germany, and are a key issue in recent health legislation. Combinations of indicators lead to indicator systems, which have to undergo validation as well. The "Kooperation für Transparenz und Qualität" (KTQ) which is now extensively used in Germany, is an example for an indicator-based accreditation system. PERSPECTIVES: Issues of further discussion are loss of validity of indicators due to awareness and alteration of documentation habits, public disclosure, and the evaluation of indicators by means of evidence-based medicine.
While vaccines have virtually eliminated many infectious diseases in Germany, vaccination coverage in children, adolescents and adults is still unsatisfying. This situation is mainly due to inadequate remuneration of vaccination services, structural deficits in the health care system and a lack of motivation. Political support and leadership would most likely be able to change this situation.