This article defines the concept of "quality management" and describes the development in quality management in Danish health care. We claim that a shift in form and focus of such management has occurred. When quality improvement was introduced as a concept in Danish health care approximately 20 years ago, the efforts started out as ad hoc projects driven by professionals. It has now taken the form of a strategic and top-down driven process in which the national health authorities play a central role. Three cases are used to illustrate this development: management of patient safety, the new Danish accreditation model and the Danish "star rating system".
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