According to Donabedian's model, what is the most important validator of the quality and effectiveness of health care in a hospital?

• A. Number of patients admitted
• B. Number of health care workers
• C. Hospital mission statements
• D. Patient outcomes achieved by the care provided

Answer: (D)

In Donabedian’s framework, the ultimate test of quality is the effect on patients’ health. The most important validator is the outcomes achieved by the care provided because they show the actual health changes that result from treatment—things like recovery, improvement in function, complication rates, readmissions, and survival. Structure describes the resources and setting, and process covers how care is delivered; both are necessary to enable good care, but they don’t prove that care changes health outcomes. Hospital mission statements reflect goals, and the number of patients admitted indicates volume, not quality. So, patient outcomes best demonstrate whether the care achieved its intended health impact.