By using available databases as well as by collecting additional data on health-related quality of life measures (enabling Quality Adjusted Life Years as an outcome measure) and patient satisfaction (including expectations) the EuroHOPE project will evaluate, through a microeconomic disease-based approach, the performance of European health care systems in terms of outcomes, quality, use of resources and cost. Concentration will be on five important health problems/diseases: acute myocardial infarction, stroke, hip fracture, breast-cancer, and very low birth weight infants. The project has the following specific aims and objectives: (i) develop methods to measure outcomes and costs of care of specific diseases that can be used for routine evaluation of care given in the whole cycle of care (not only for specific procedures or short episodes); (ii) develop methods to measure quality, access, outcomes and cost of (care) that can be used for routine evaluation and monitoring of the performance, and give a recommendation of a list of indicators to be routinely collected and published by the EU (as a part European community Health Indicators); (iii) develop methods for international comparative health service research using register data; (iv) investigate the relationship between outcomes (or quality) with costs (or other measures of use of resources) between European countries, regions and providers applying a multilevel approach; (v) explore reasons behind difference in outcomes and costs. In particular, the interest will be on policy driven factors (such as treatment practices, use of medicines and modern technology, waiting times, financing, organisation of delivery, and reforms); (vi) give proposals concerning the data content of national level registers and outcome measurements in order to improve the continuous monitoring of performance on an intra- and international level; and (vii) implementing European-wide benchmarking on outcomes, quality and costs, which ena