OBJECTIVES: Quality management is an essential element of health care. In countries where health systems are characterized by high level of efficiency, quality programs are employed to ensure certain standards of medical services and patients’ safety. This paper aims to explore what methods of implementation and forms of peer pressure mechanism, as a part of quality improvement initiatives, are present in selected health systems and what is their impact on quality and costs of healthcare.

METHODS: A systematic review based on publications identified in PubMed database was conducted. A developed search strategy was used to select relevant papers published up to 30^th May 2017.

RESULTS: Of the 471 references identified, data was collected from 17 studies (15 prospective and 2 retrospective). Publications covered many areas of healthcare including primary, specialized, ambulatory and hospital care. Evaluation of outcomes in 4 studies was based on data collected from questionnaires completed by members of medical stuff. In 15 studies healthcare providers and medical stuff received feedback concerning their performance of provided medical care. In majority of publications quality indicators were recognized as a useful tool for quality assessment. Researches selected for the systematic review confirmed presence of the peer pressure mechanism in examined health systems. Studied tool for quality improvement was implemented in different forms and with the reference to all identified publications, it applied to every level of healthcare. Its positive effect on quality and safety of medical services was demonstrated.

CONCLUSIONS: The obtained results partly confirmed an initial hypothesis, in which positive impact of peer pressure mechanism on quality and costs of analysed health systems, was assumed. In order to fully confirm it, a further research, which would include publications referring to wider range of counties, is recommended.