Towards Evidence-based Government Supervision in Healthcare

Abstract

Little is known about the actual effects of the supervision programmes of healthcare inspectorates on quality of care. Therefore, the aim of this thesis is to generate empirical evidence of the effects of government supervision on quality of care and specifically health outcomes. We conclude that one supervision programme probably was effective at improving quality of care. We found no evidence that the other theme-based supervision programme also improved quality of care, but given the methodological shortcomings we also cannot exclude the possibility that the supervision programme had an effect on structures and processes of care. In addition, we conclude that the relation between structures and processes of care and health outcomes, which (by definition) can be assumed to exist in the case of evidence-based structures and processes, is difficult to demonstrate using observational data. To improve future research on the effectiveness of supervision, we propose to extend the methodological criteria for this type of research.