[Theoretical basis for health system performance assessment]

In France, the search for improved performance in the public sector, considered to reflect optimization of public services, has undergone various phases since the second World War. Public policy assessment has also considerably developed since the 1990s. The various reforms and resulting programmes have contributed to changing the French public administration from a means-based approach to a results-based approach, an essential step to improve performance according to the New Public Management paradigm. Other theories have also been proposed concerning performance assessment in the public sector, especially the medical care sector. The primary objective of this article is to propose a theoretical framework for the concept of performance and performance assessment in the health sector. The authors also propose a reading grid of the main theories concerning application of performance assessment in the health care sector.