Collecting patient experience data is of great importance for a comprehensive assessment of medical care quality. A practice accreditation programme that includes a structured patient survey can be considered as a high international standard. So far, there are insufficient research results on how and to what extent patient experience data is to be included in the accreditation decision.

COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe. What is Known: • Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes. • There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care. What is New: • A set of 42 quality indicators for primary paediatric care in Europe was developed in a multi-country collaborative effort. The method combined a systematic literature review and a consensus process among European paediatric experts. • The quality indicator set can facilitate quality improvement of PPC. After studying the feasibility, providers can use COSI-PPC-EU to monitor, compare and improve performance of practices, regions and countries.

All factors studied, specifically the patients' self-rated health, affected patient satisfaction. Adjustment should always be considered because it improves the comparability of patient satisfaction in medical practices with atypically varying patient populations and increases the acceptance of comparisons.

BackgroundPublic reporting of hospital quality is to enable providers, patients and the public to make comparisons regarding the quality of care and thus contribute to informed decisions. It stimulates quality improvement activities in hospitals and thus positively impacts treatment results. Hospitals often use publicly reported data for further internal or external purposes.As of 2005, German hospitals are obliged to publish structured quality reports (QR) every two years. This gives them the opportunity to demonstrate their performance by number, type and quality in a transparent way. However, it constitutes a major burden to hospitals to generate and publish data required, and it is yet unknown if hospitals feel adequately represented and at the same time consider the effort appropriate.This study assesses hospital leaders’ judgement about the capability of QR to put legally defined aims effectively and efficiently into practice. It also explores the additional purposes hospitals use their QR for.MethodsIn a cross-sectional observational study, a representative random sample out of 2,064 German hospitals (N=748) was invited to assess QR via questionnaire; 333 hospitals participated. We recorded the suitability of QR for representing number, type and quality of services, the adequacy of cost and benefits (6-level Likert scales) and additional purposes QR are used for (free text question). For representation purposes, the net sample was weighted for hospital size and hospital ownership (direct standardization). Data was analyzed descriptively and using inferential statistics (chi-2 test) or for the purpose of generating hypotheses.ResultsGerman hospitals rated the QR as suitable to represent the number of services but less so for the type and quality of services. The cost-benefit ratio was seen as inadequate. There were no significant differences between hospitals of different size or ownership.Public hospitals additionally used their reports for mostly internal purposes (e.g. comparison with competitors, quality management) whereas private ones used them externally (e.g. communication, marketing) (p=0.024, chi-2 test, hypotheses-generating level).ConclusionsGerman hospitals consider the mandatory QR as only partially capable to put the legally defined aims effectively and efficiently into practice. In order for public reporting to achieve its potentially positive effects, the QR must be more closely aligned to the needs of hospitals.

Aim In order to generate ideas for the improvement of German accreditation programmes, we aimed at exploring similarities and differences of nine international approaches to the accreditation of ambulatory primary and specialist care facilities. Subjects and methods Nine accreditation programmes from Germany, Switzerland, the Netherlands, Great Britain, the USA, and Australia were included. Selective literature review, systematic analysis of the documents identified, and descriptive comparison of findings regarding key information on accreditation standard development, contents, and methods of accreditation; inclusion of patient surveys; and special features were performed. Results All practice accreditation programmes include a consensus process to develop mainly quality managementbased criteria for practices' structures and processes. Several accreditation programmes require structured patient surveys. All accreditation processes include a selfassessment, a review and verification of documented evidence, and a peer-based on-site visit. Some accreditation programmes show unique features, such as a high degree of external consultation and support, or a link of accreditation to pay-for-performance programmes. Conclusion Comparison of international accreditation programmes of ambulatory primary and specialist care facilities reveals considerable similarities in regard to the development of accreditation criteria, the criteria themselves, and the process of accreditation. German practice accreditation programmes may benefit from including a structured patient survey, a higher degree of consultative support, and financial incentives.