Widening the scope of accreditation--issues and challenges in community and primary care.

Accreditation systems first developed to improve the quality of hospital care. As health care systems move towards a greater emphasis on primary and home care, accreditation systems are developing to address quality in this more diverse sector. This is more problematic, since there is little agreement about the precise functions to be undertaken in non-hospital care and there is no uniform organizational structure. This paper addresses the issues raised in developing quality in these very different organizations and examines the progress being made.