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Measuring health system performance.

P C Smith

    The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care
    |December 21, 2004
    PubMed
    Summary
    This summary is machine-generated.

    Effective health system performance measurement hinges on accurate data, clinician engagement, and organizational culture. Properly implemented systems offer a cost-effective strategy for significant health system improvements.

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    Area of Science:

    • Health Services Research
    • Public Policy
    • Organizational Behavior

    Background:

    • Health system performance improvement is a critical policy objective in developed countries.
    • Numerous initiatives are underway to measure and enhance health system performance.
    • This paper analyzes performance measurement through a principal/agent framework.

    Discussion:

    • The efficacy of performance measurement systems is contingent upon four crucial elements.
    • These elements include the alignment of performance measures with system objectives, data quality, clinician incentives, and organizational culture.
    • The principal/agent theory provides a lens to understand these dynamics.

    Key Insights:

    • Performance measures must accurately reflect system goals for effectiveness.

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  • High-quality data and strong incentives are vital for clinician engagement with performance data.
  • A supportive organizational culture is essential for the successful deployment of performance measurement systems.

    • Outlook:

    • Optimal performance measurement system design is context-dependent.
    • When implemented effectively, these systems represent a cost-efficient tool for substantial health system enhancement.
    • Further research into context-specific optimal designs is warranted.