There is growing interest in the systematic assessment and international benchmarking of quality of care provided in different healthcare systems, and major work is under way to support this process through the development and validation of quality indicators that can be used internationally. This is not an easy thing to do, as cross-national data comparison remains a challenge. This RAND report focuses on the three quality domains, namely effectiveness of care, patient safety and patient experience. The objective is to assess the causes underlying international differences and determining what actions may be appropriate to take to improve health outcomes.