Avedis Donabedian

Avedis Donabedian (7 January 1919 – 9 November 2000) is the Father of Quality and systemic approach in healthcare services; he was a physician and founder of the study of quality in health care and medical outcomes research, most famously as a creator of The Donabedian Model of care.

Donabedian collated the growing literature of health services research as it appeared through the 1950s and early 1960s and presented his findings in a lengthy paper in 1966 with the title “Evaluating the Quality of Medical Care”. In it he sets out the necessity of examining the quality of health provision in the aspects of structure, process and outcome.

Much of his subsequent work was a detailed exposition of the concepts and methods required to examine these fundamental aspects of health care. He was an early exponent of systems management in health services. He strove to define every aspect of quality in health systems and proposed models for its measurement in over 100 papers and 11 books. These include access to health care, completeness and accuracy in medical records, observer bias, patient satisfaction, and cultural preferences in health care. The summation of his efforts is found in his trilogy, Explorations in quality assessment and monitoring (1980–85), a massive work of personal scholarship and analytical thought brought to bear on every aspect of health care provision. Here he suggests seven pillars of quality: efficacy, efficiency, optimality, acceptability, legitimacy, equity, and cost.

In 1986 he received the Health Services Research Prize. A testimony to this influence is the existence of the Avedis Donabedian Foundation for the Improvement of Health Care in Barcelona, Spain, and of several awards bearing his name.