Donabedian model
Quality Management
Definition. The Donabedian model evaluates quality of care through three linked dimensions: structure, process and outcome.
Explanation
Donabedian first set out this framework in 1966 (Donabedian, 1966) and later refined it, arguing that good structure increases the likelihood of good process, which in turn increases the likelihood of good outcomes (Donabedian, 1988). He also traced the idea of measuring end results back to Ernest Codman (Donabedian, 1989).
The model remains the most widely used framework for selecting quality indicators. Its limits include the assumption of linear links between dimensions and limited attention to patient experience and context.
Related concepts
Quality indicator Quality improvement Patient experience Accreditation Value-based healthcare
Read on The Health Topics
- The Limits Of Explicit Criteria: An Epistemic-Tension Analysis of Donabedian’s 1981 Text, a Reverse Reading Through AGREE–GRADE–NICE, and a Counterfactual Interpretation for the Machine-Learning Era
- Predictive Quality: An Introduction 101
- Ernest Codman: Pioneer of Healthcare Quality Assessment
References
Donabedian, A. (1966). Evaluating the quality of medical care. The Milbank Memorial Fund Quarterly, 44(3), 166–206. https://doi.org/10.2307/3348969
Donabedian, A. (1988). The quality of care: How can it be assessed? JAMA, 260 (12), 1743–1748. https://doi.org/10.1001/jama.260.12.1743
Donabedian, A. (1989). The end results of health care: Ernest Codman’s contribution to quality assessment and beyond. The Milbank Quarterly, 67 (2), 233–256. https://doi.org/10.2307/3350149
Cite this entry: Kurutkan, M. N. (2026). Donabedian model. In The Health Topics glossary. https://healthtopic.org/glossary/donabedian-model/