Original ArticlesAn Evidence-Based Evaluation of Quality and Efficiency IndicatorsGandjour, Afschin; Kleinschmit, Frauke; Littmann, Valerij; Lauterbach, Karl WilhelmAuthor Information Afschin Gandjour, MD, MBA, is a research fellow, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany. Frauke Kleinschmit, MD, is a medical resident, Johanniter Hospital, Department of Medicine I, Duisburg, Germany. Valerij Littmann, MD, is a medical resident, Hohenfeldklinik Bad Camberg, Bad Camberg, Germany. Karl Wilhelm Lauterbach, MD, DSc, is director, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany. The authors would like to thank Noelle Aplevich, MA, for her very valuable comments on an earlier draft. Quality Management in Health Care: Summer 2002 - Volume 10 - Issue 4 - p 41-52 Buy Abstract The goal of this study was to identify and appraise quality and efficiency indicators relevant to hospitals or physicians' practices by performing a systematic literature search. Process indicators were limited to 11 diagnoses and treatments. To appraise the indicators identified, a framework for grading health care recommendations was expanded to categorize evidence on cost-effectiveness. Seven indicators of structural quality and 34 indicators of process quality were identified and appraised. The set of performance indicators could serve as a state-of-the-art system of measurement for governments and organizations evaluating the quality and efficiency of health care. © 2002 Lippincott Williams & Wilkins, Inc.