Methods for external evaluation of health care institutions.

OBJECTIVE: To compare the methods used by external evaluators of health care institutions in Europe.
METHODS: A common framework for analysis was designed by the authors and shared among the members of the ExPeRT Project. Each member prepared a description of a model and the results were compared in two workshops.
RESULTS: Programmes share similarities in the methods used, but they differ in the focus and purpose of the evaluation. Differences in focus included whether a part or the whole of the institution is analysed and whether the review is patient or system centred. Different purposes of the programmes are reflected in the emphasis and use of the methodological tools: for instance, the appeal system is used only in the programmes that provide a certificate to the institution audited.