Health systems and hospitals in Australia and overseas have traditionally evaluated their activities on inputs and outputs and continue to do so. There has been a major focus on the efficiency of service throughputs rather than the effectiveness of interventions. It is only relatively recently that health system evaluation has also focused on evaluating processes and now, outcomes. While we are benchmarking hospital services with regard to cost, we may also wish to increasingly benchmark these services with regard to indicators of quality, and to undertake these activities in an integrated way. The assessment of quality and health outcome must become an integral feature of the model of care.