Editor's Preface

The concern with measuring the performance of health systems and health care is not recent. In the 1860s Florence Nightingale pioneered the systematic collection, analysis and dissemination of comparative hospital outcomes data in order to understand and improve performance. Fifty years later, Ernest Codman promoted the need for scrupulous collection and public release of surgical outcome data (Spiegelhalter, 1999). However, there were many practical, professional and political impediments to making such principles operational. It is only in the last ten years that the vision of using large-scale data sources to help improve health system performance has become a reality...