Two different regulatory approaches can be applied in this regard. The first
option is public regulation, established by the government’s health policy. The
application of public regulations can be assigned to government bodies, selfgoverning
bodies in the sector or corporatist bodies. The second option is
self-regulation, set up and applied by medical providers themselves and
their self-governing bodies. Self-regulation has a long tradition in Germany
(Altenstetter and Busse, 2005) and occurs as a private solution – often voluntarily
as a means of preventing public regulation. In both settings, the key is
reliable information about quality (and efficiency). Such information must be
available for patients (or their trusted agents) to compare providers and motivate
careful choices (Ginsburg, 2005: 1520f.). Quality of care can be measured
under three dimensions: structure, process, and outcome (Donabedian, 1980),
with different indicators and different measurement costs for each.