Measures of process of care have substantial advantages over
outcomes. Firstly, the process of care is more directly in the control
of the doctor, so problems of attribution are greatly reduced.
Secondly, the measures are less influenced by the complexity of
patients’ problems – for example, doctors continue to monitor
HbA1c regardless of the severity of the diabetes. Thirdly, some
of the process measures, such as immunisation, should be offered
to all patients of a particular type, reducing the problems of
case mix