Quality in primary health care: A multidimensional approach to complexity

Date of this Version


Document Type

Journal Article

Publication Details

Published Version.

Heath, I., Rubinstein, A., Stange, K. & van Driel, M. L. (2009). Quality in primary health care: A multidimensional approach to complexity. BMJ, 338(7700), 911-913.

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2009 HERDC submission. FoR code: 1103

© Copyright the Authors, 2009


In his 1913 novel Chance, Joseph Conrad wrote about the changing fashion for certain words: "You know the power of words. We pass through periods dominated by this or that word—it may be development, or it may be competition, or education, or purity or efficiency or even sanctity. It is the word of the time." Today’s word is quality. In order to assess the quality of primary health care, we have to define what quality means in this context. But who should make the definition, and whose perspective should take priority? The easy assumption is that quality should be defined by patients rather than by policymakers, politicians, or healthcare professionals—but who is the representative patient? How generalisable can any measure of the quality of primary health care be across different economic, social, and cultural contexts?



This document has been peer reviewed.