A Conceptual Framework to Measure Performance of the Public Health System

Handler, Arden; Issel, L. Michele; Turnock, Bernard J.

doi:10.2105/ajph.91.8.1235

Cited by 248 publications

(224 citation statements)

References 13 publications

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“…This entails including patients, service users (or 'consumers') and the general public when making decisions and aims to ensure that all decisions are informed, transparent and legitimate (Handler et al, 2001;Abelson, 2003). However, typical elicitation experiments lack realism, and often reduce the decision-making question to a handful of programs which do not capture the set of value trade-offs that health systems regularly make.…”

Section: Health System Performance Indicatorsmentioning

confidence: 99%

Identifying health system value dimensions: more than health gain?

Costa‐Font

Sato

Forns

2017

HEPL

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Publicly funded health system reforms increasingly require the evaluation of competing programs with multidimensional attributes including both health and non-health outcomes (values). This paper identifies the design and implementation of a methodology that validates health priority setting. The exercise suggests that the proposed mixed methods methodology is suitable for eliciting and validating health system values, and its findings show that pursuing health gain alone does not fully capture the dimensions of health system value. More specifically, we identify a list of health system values (elicited by both potential and actual users) and classify them in terms of process related values (e.g., shorter waiting lists, greater choice etc) and improvements in health system equity in addition to value derived from health gain.

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Section: Health System Performance Indicatorsmentioning

confidence: 99%

Identifying health system value dimensions: more than health gain?

Costa‐Font

Sato

Forns

2017

HEPL

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“…This is particularly relevant for new developments in domains, including those concerning diagnostic/treatment procedures, inter-operability, and the use of new medical devices [12]. Besides quality metrics it is necessary to synthesize data in a conceptual model contemplated for global quality assessment and health system monitoring [7]. The conceptual system, here considered to measure the quality of the health system, is derived from the measurement approach proposed by Donabedian and widely accepted in the literature [13].…”

Section: Quality Measurements In Health Systemsmentioning

confidence: 99%

“…The approach by Donabedian combines several issues, related to the organizational structure, processes, and outcomes, in a comprehensive clinical model. In particular, the health system is split into four conceptual components: mission, structural capacity, processes and outcomes, all interacting with the macro context [2,5,7,14]. From this division in different areas the evaluation of reference indicators and/or parameters, is a technique widely used in healthcare.…”

Section: Quality Measurements In Health Systemsmentioning

confidence: 99%

“…The goal is a first characterization of the individual components and the successive study of inter-relationship between them to improve the outcome in the individual patient. For this the model proposed by Donabedian [6] and integrated by Handler et al [7] is widely accepted and proposed in many studies [1] for the characterization and the measure of the quality in healthcare.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of indices for the measurement of quality in health systems

Clemente

Papi

Pontecorvi

et al. 2016

Int. J. Metrol. Qual. Eng.

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Abstract. In recent decades different numeric indicators and methods have been used to qualify structured index that express health service components quality performance. The first step of this work is the definition of a model of the system under examination in order to define its measurable constituent entities (dimensions). Among the common measured clinical parameters, a robust metrics, characterizing the constituent entities and the best opportunity tools for the characterization of the results, have been identified. The last step is multimodal analysis of the results. Using this approach the paper presents an application in the evolution of the cardiological intensive care unit (ICU). Particularly, the attention of this paper is focused on the evolving of the medical team.

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“…However, there is little ability to directly relate populationwide outcomes to specific activities of the governmental public health enterprise. 12 As a result, to affirm the public health contribution to this public good, there is a need to examine these questions through a different lens. n Spending assessment.…”

Section: Governmental Public Health By the Late 1990s: Vital Signsmentioning

confidence: 99%

Governmental Public Health In The United States: The Implications Of Federalism

Turnock¹,

Atchison²

2002

Health Affairs

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Governmental public health activities in the United States have evolved over time as a result of two forces: the nature and perceived importance of threats to the population's health and safety, and changing relationships among the various levels of government. Shifts toward a more state-centered form of federalism in the second half of the twentieth century weakened key aspects of the governmental public health enterprise, including its leadership and coordination, by the century's end. These developments challenge governmental public health responses to the new threats and increased societal expectations of the early twenty-first century.Many are the exercises of power reserved to the States wherein a uniformity of proceeding would be advantageous to all. Such are quarantines and health laws. 1 Thomas Jefferson, 1807T h e f e d e r a l i s t s ys t e m of American government, marked by the distribution of responsibilities among its national, tribal, state, and local components, is an essential contributor to our public health aspirations. Each component contributes in various ways, and to varying degrees, to assessing, addressing, and assuring conditions in which people can be healthy. Although constitutional and legal frameworks define the basic functions and roles of the various levels of government, an even more complex web of intergovernmental relationships characterizes the operational aspects of federalism. 2 These operational relationships influence the ability of the overall governmental public health enterprise to protect and promote the health of the public.To a large degree, the organization, financing, and delivery of public health ser-

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A Conceptual Framework to Measure Performance of the Public Health System

Abstract: A conceptual framework that explicates the relationships among the various components of the public health system is an essential step toward providing a science base for the study of public health system performance.

Cited by 248 publications

References 13 publications

Identifying health system value dimensions: more than health gain?

Identifying health system value dimensions: more than health gain?

Evaluation of indices for the measurement of quality in health systems

Governmental Public Health In The United States: The Implications Of Federalism

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