How to detect the variation in the quality of care in all major health care systems (Schuster, Marshall, Cambell, &Roland,1998; Seddon, Marshall, Cambell, & Roland, 2001) is another main issue to be discussed. United Kingdom (Doran et al, 2006) introduced a pay-for-performance contract for family practitioners according to performance with respect to 146 quality indicators covering clinical care for 10 chronic diseases, organization of care, and patient experience.