Avedis Donabedian

Avedis Donabedian (7 January 1919 – 9 November 2000) was a physician and founder of the study of quality in health care and medical outcomes research, most famously as a creator of The Donabedian Model of care.

Avedis Donabedian was born in Beirut, Lebanon, in an Armenian family from Turkey who escaped the Armenian Genocide and came to Palestine, although the rest of their families perished. His father had recently qualified as a doctor at the American University of Beirut in Lebanon and soon after set up practice in the small Christian town of Ramallah, near Jerusalem. Donabedian received his early education at the Friends’ (Quaker) school there and subsequently followed his father in studying medicine at the American University of Beirut.

Donabedian received the degree of BA in 1940 and MD in 1944 and subsequently worked at the English Mission Hospital in Jerusalem, making a brief trip to England. As local war broke out over the partition of Palestine in 1948, he moved to the American University of Beirut where he occupied a number of teaching positions and became medical officer to the whole university. He became aware of his limitations as an administrator and developed a growing interest in the quality of health provision and in public health. An opportunity arose to study epidemiology and health services administration at Harvard, where he received his MPH degree (magna cum laude) in 1955. Not wishing to return to Lebanon due to political unrest, he received sponsorship to stay in the USA with his wife and children. He became a non-clinical teacher and researcher at New York Medical College from 1957 to 1961, when he was recruited by the School of Public Health at the University of Michigan. He spent the rest of his professional life there, becoming Nathan Sinai Distinguished Professor of Public Health in 1979, and continuing to work as emeritus professor until his death, in Ann Arbor, Michigan, USA, in 2000.

Donabedian collated the growing literature of health services research as it appeared through the 1950s and early 1960s and presented his findings in a lengthy paper in 1966 with the title “Evaluating the Quality of Medical Care”. This summation and analysis brought him immediate fame and is still widely cited and read: it was reprinted by The Milbank Quarterly in 2005. In it he sets out the necessity of examining the quality of health provision in the aspects of structure, process and outcome.

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