A framework to measure the value of public health services

To develop a framework that public health practitioners could use to measure the value of public health services.

Primary data were collected from August 2006 through March 2007. We interviewed (n=46) public health practitioners in four states, leaders of national public health organizations, and academic researchers.

Using a semi-structured interview protocol, we conducted a series of qualitative interviews to define the component parts of value for public health services and identify methodologies used to measure value and data collected.

The primary form of analysis is descriptive, synthesizing information across respondents as to how they measure the value of their services.

Our interviews did not reveal a consensus on how to measure value or a specific framework for doing so. Nonetheless, the interviews identified some potential strategies, such as cost accounting and performance-based contracting mechanisms. The interviews noted implementation barriers, including limits to staff capacity and data availability.

We developed a framework that considers four component elements to measure value: external factors that must be taken into account (i.e., mandates); key internal actions that a local health department must take (i.e., staff assessment); using appropriate quantitative measures; and communicating value to elected officials and the public.