background During recent years mental health care has undergone tremendous developments both from a scientific and organisational point of view. The government, the health insurance companies and the patient advocacy movement increasingly expect accountability of the efficacy, effectiveness and client centeredness of the care that is provided. This development has stimulated a more businesslike approach to care, within which 'quality of care' has become a key concept.
aim For many practising psychiatrists the field of 'quality care' is relatively unknown. In this first article of two we give a historical and conceptual overview of quality-mindedness in psychiatric practice and we will describe the main 'quality systems'.
method Key publications on the subject and a Medline search (1995- now) have been used.
results and conclusion 'Qualit y of care' is a container concept within which diverging perspectives of professional care providers, policy makers and patients can be integrated within a single frame of reference. It is a new research paradigm within which 'value-based' and 'evidence-based' approaches can be reconciled. It can be an instrument to support policy decisions. Research will have to establish whether this instrument is cost-effective.