The evaluation of performance and cost in a hypertension control program

Area of Science:

• Public Health Management
• Health Services Research
• Program Evaluation

Background:

• Current evaluation designs for public health departments exhibit significant weaknesses.
• There is a need for improved methods to assess performance and cost-effectiveness in public health programs.
• Existing evaluation tools often do not meet the needs of on-line managers for day-to-day supervision.

Purpose of the Study:

• To introduce and describe the Performance Measurement System (PMS) as a novel approach for evaluating public health department performance and costs.
• To detail the methodology and implementation steps of the PMS.
• To demonstrate the practical application of PMS in hypertension control programs.

Main Methods:

• The Performance Measurement System (PMS) adapts a systems approach using epidemiologic and industrial engineering concepts.
• PMS involves six key implementation steps: systems design, objective formulation, gauge development, and creation of performance, efficiency, cost-effectiveness, and staff support indicators.
• Methods for analyzing PMS indicators are examined.

Main Results:

• The PMS methodology has been successfully applied to the Detroit Hypertension Control Program, a large-scale demonstration project.
• Implementation in the Connecticut State Health Department's Preventable Disease Division showcases its versatility.
• Detailed examination of PMS performance and cost indicators for the Detroit project provides practical insights.

Conclusions:

• The Performance Measurement System (PMS) offers a robust framework for evaluating public health programs.
• PMS provides on-line managers with essential tools for supervision and performance assessment.
• The system's adaptability is demonstrated through its successful application in diverse public health settings, including hypertension control.