Measurement of quality of care. Comparison of voluntary versus obligatory data collection for the hospital based stroke register Hessen, Germany

Background and purpose: The stroke register Hesse started 1997 as a project of voluntary external quality control (VQC). Since 2004 participation is obligatory (OQC) for every department in the country Hesse (6 million inhabitants) treating acute stroke patients. The intention was to obtain a comprehensive image of the quality of care. Quality indicators (QI's) were developed in parallel to provide feed back for the participants and a basis for dialog. We hypothesised to obtain a higher dispersion measuring QI's with obligatory participation. Methods: Two periods 1999–2002 (VQC) and 2004–2005 (OQC) were compared…