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The paper discusses empirical Bayes methodology for repeated qualitycomparisons of health care institutions using data from the Dutch VOKS studythat annually monitors the relative performance and quality of nearly all Dutchgynecological centres with respect to different aspects of the childbirthstaking place in these centres. This paper can be seen as an extension of thepioneering work of Thomas, Longford and Rolph and Goldstein and Spiegelhalter.First of all, this paper introduces a new simple crude estimate of the centreeffect in a logistic regression setting. Next, a simple estimate of theexpected percentile of a centre given all data and a measure of rankability ofthe centres based on the expected percentiles are presented. Finally, thetemporal dimension is explored and methods are discussed to predict next yearsperformance.

Empirical Bayes methods for monitoring health care quality